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Case Report
 
Primary cytomegalovirus infection presenting with itching and obstetric cholestasis like picture in mid-trimester
Osama Eskandar1, Georgia Smith2
1MRCOG - MFSRH, Departments of Obstetrics and Gynaecology, North Devon District Hospital, Devon, EX31 4JB, Barnstaple, UK.
2Department of Obstetrics and Gynaecology, South Devon District Hospital, Torquay, Devon, TQ2 7AA, Barnstaple, UK.

Article ID: 100002Z08OE2015
doi:10.5348/Z08-2015-2-CR-2

Address correspondence to:
Osama Eskandar
MRCOG - MFSRH, Departments of Obstetrics and Gynaecology
North Devon District Hospital
Devon EX31 4JB, Barnstaple
UK
Phone: +44 (0) 1271378803
Fax: +44 (0) 7710537588

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How to cite this article:
Eskandar O, Smith G. Primary cytomegalovirus infection presenting with itching and obstetric cholestasis like picture in mid-trimester. J Case Rep Images Gynecol Obstet 2015;1:5–7.


Abstract
Introduction: We present a case of Primary cytomegalovirus infection presented in mid-trimester with itching and obstetric cholestasis like picture. To the best of our knowledge the similarities between primary CMV and obstetric cholestasis, when presenting during pregnancy, have not been highlighted before in the literature.
Case Report: A 36 year old lady presented to antenatal clinic at 23+4 weeks gestational age with intense itching. Bile acids and ALT were raised so she was treated as obstetric cholestasis whilst other results were awaited. Cytomegalovirus (CMV) antibodies, immunoglobulin G (IgG) and IgM were positive despite being negative at booking, suggesting an acquisition of CMV at approximately 18 weeks gestation. This article highlights the details of her case including the management and consequences of cytomegalovirus in pregnancy.
Conclusion: This case report highlights the importance of the awareness of the clinicians with the condition as a differential diagnosis to obstetric cholestasis. CMV should be considered in the work up investigation of itching and abnormal liver functions in pregnancy.

Keywords: Cytomegalovirus infection, Herpes virus, Primary CMV infection with pregnancy


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Author Contributions
Osama Eskandar – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
Georgia Smith – Analysis and interpretation of data, Revising it critically for important intellectual content, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 Osama Eskandar et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.