Cytomegalovirus Induced Thrombocytopenia in an Immunocompetent Patient

Cytomegalovirus (CMV) is a common human herpesvirus that can lead to a variety of clinical manifestations. We report the case of a 40-year-old previously healthy male who presented with a one-week history of easy bruising, fatigue, and pallor. Physical examination revealed multiple petechiae on both lower limbs. The patient’s platelet count was significantly low. Given the clinical presentation and absence of other clear etiologies, a thorough workup was initiated, including viral serologies. Testing revealed a positive result for cytomegalovirus (CMV) IgG, suggesting acute CMV infection. Further investigation confirmed CMV-induced thrombocytopenia, with viral DNA detected in the patient’s blood. The patient started antiviral therapy with ganciclovir and pulse therapy of methylprednisolone. Over the following week, platelet counts gradually improved, and the patient’s symptoms of fatigue and easy bruising resolved. These cases highlight the importance of considering CMV as a potential cause of thrombocytopenia, particularly in patients with nonspecific symptoms like bruising and petechiae. Early diagnosis is critical for effective management, which includes antiviral therapy and supportive care. Clinicians should be aware that CMV-induced thrombocytopenia can occur in immunocompetent individuals, and prompt intervention can lead to favorable outcomes.