Anasarca secondary to cytomegalovirus viremia in a post-liver transplant patient

Cytomegalovirus (CMV) infection should be considered in the differential diagnosis of unexplained anasarca and refractory ascites in liver transplant recipients, even in the absence of graft dysfunction or classic CMV symptoms.A systematic evaluation to exclude cardiac, renal, vascular and graft-related causes of fluid overload is essential before attributing post-transplant anasarca to non-infectious aetiologies.Early recognition and treatment of CMV viremia can lead to clinical improvement and optimise outcomes in immunosuppressed patients.