Suspected CMV Associated Myelitis in Immunocompetent Adult without Supporting PCR from the CSF

The occurrence of Cytomegalovirus (CMV) myelitis among immunocompetent patients is extremely uncommon. We present a 53 year old immunocompetent female with myelitis that was associated with infection of CMV that was detected by positive Immunoglobulin M (IgM) antibodies, seroconversion of Immunoglobulin G (IgG) antibodies with low avidity index, but the polymerase chain reaction (PCR) test for CMV in the cerebrospinal fluid (CSF) was negative. We suggest here, that the absence of supporting PCR from CSF or blood CMV antigen should not exclude the diagnosis, especially in the immunocompetent patients.