Acute Granulomatous Hepatitis

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Abstract
Two previously healthy adults with acute granulomatous hepatitis attributable to cytomegalovirus (CMV) mononucleosis had prolonged fever, heterophil-negative lymphocytosis with numerous atypical forms, minor alterations in hepatic function, and evidence on biopsy, of a nonspecific acute hepatitis with granulomata. Infection with CMV was corroborated by a rising titer of complement-fixing antibody in case 1 and by a high titer of antibody that later fell in case 2. It is important to exclude CMV infection as an etiologic factor in cases of acute granulomatous hepatitis and fever of unknown origin. (JAMA233:1284-1288, 1975)