巨細胞病毒感染症常發生在長期免疫抑制藥物之器官移植患者身上，但發生在短期使用免疫抑制劑之慢性腎絲球腎炎病患上卻少有報告。我們提出一個罹患膜性腎絲球腎炎的糖尿病患使用免疫抑制劑產生巨細胞肺炎的病例報告。病患以呼吸衰竭表現，在胸部X 光和電腦斷層檢查兩肺葉都有浸潤現象，肺泡灌洗樣本培養證實了巨細胞病毒感染症，同時周邊血液樣本在聚合酵素連鎖反應檢查下也發現巨細胞病毒存在的強烈證據。立刻使用抗病毒Gancyclovir藥物治療，經過一個月，該患者之症狀、血氧濃度、胸部X 光都有改善，但肺功能檢查顯示仍有嚴重的侷限性肺疾及氣體交換障礙，仍需要長期氧氣治療。根據文獻回顧，糖尿病、對類固醇反應不好的腎絲球腎炎、及使用環孢靈(cyclosporine) 都會增加巨細胞病毒感染機會。當臨床上需要使用免疫抑制藥物的病人，醫師對所產生的感染和後遺症應該要特別小心，早期發現及早期治療是解決此類問題的不二法門。

Cytomegalovirus (CMV) disease is not uncommon upon an acquired immune compromised status like organ transplant recipients. However, the complication of short-term immunosuppressive therapy for non-transplant patients was not known very well. Here we reported a case of CMV pneumonitis presented with life threatening respiratory failure in a patient with diabetes and steroid-resistant
membraneousglomerulonephropathy who underwent immunosuppressant therapy. Chest X-ray and high resolution computed tomography scan revealed interstitial pneumonitis over both lungs. A virus isolation culture of bronchoalveolar lavage fluid and deoxyribonucleic acid polymerase chain reaction in peripheral blood showed positivity for CMV. After one month of ganciclovir therapy, the patient's symptoms improved and lung infiltration resolved. However, post-infection sequela of severe restrictive lung disease occurred and oxygen therapy was maintained after his discharge. CMV lung infection may be mainly due to immune compromised
status in the present case of diabetes, steroid-resistant glomerulopathy, and treatment with cyclosporine immunosuppressant. A high index of suspicion and early initiation of antivirus therapy are mandatory for the
successful management of opportunistic CMV pneumonitis and the sequelae in patients receiving immunosuppressive therapy.