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Investigations revealed elevated liver enzymes, leukopenia, spherocytosis and lower lobe predominant consolidations and diffuse nodules in the high\u2010resolution computed tomography. He was suspected to have cytomegalovirus (CMV) pneumonia with the above results, and further investigations revealed an extremely elevated CMV viral load. He was treated with ganciclovir followed by valganciclovir for a total of 42\u2009days resulting in a complete recovery. Liver functions resolved with anti\u2010viral treatment, and he was started on full anti\u2010tuberculosis (TB) treatment. Further investigations did not reveal evidence of immunosuppression. Association of CMV and TB is explained genetically, although clinical association is rarely described. The presence of either infection should lead to higher degree of suspicion of the respective other condition in relevant clinical setting.<\/jats:p>","DOI":"10.1002\/rcr2.1002","type":"journal-article","created":{"date-parts":[[2022,7,8]],"date-time":"2022-07-08T06:41:56Z","timestamp":1657262516000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Cytomegalovirus pneumonia in a background of central nervous system tuberculosis"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6372-3263","authenticated-orcid":false,"given":"Sugeesha","family":"Wickramasinghe","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine Central Chest Clinic  Borella Sri Lanka"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Menaka","family":"Tillekeratne","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine Central Chest Clinic  Borella 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