Cytomegalovirus and the Seemingly Immunocompetent Host: A Case of a Perforating Gastric Ulcer

Krajicek, Edward; Shivashankar, Raina; Hansel, Stephanie L.

doi:10.14309/crj.2017.27

Cited by 5 publications

(7 citation statements)

References 10 publications

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“…Even in younger patients with no reported comorbidities, a certain subset presenting with CMV colitis is soon after diagnosed with IBD [ 40 ]. Patients with prominent tissue-invasive CMV should therefore be closely evaluated for immunocompromising conditions, concurrent IBD, or an alternative diagnosis ( Figure 1 ) [ 41 , 42 ].…”

Section: CMV In the General Population: Presentation Diagnosis Amentioning

confidence: 99%

A Practical Review of Cytomegalovirus in Gastroenterology and Hepatology

Fakhreddine

Frenette

Konijeti

2019

Gastroenterology Research and Practice

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Human cytomegalovirus (CMV) is a ubiquitous Herpesviridae virus with a wide spectrum of pathology in humans. Host immunity is a major determinant of the clinical manifestation of CMV and can vary widely in the gastroenterology and hepatology practice setting. Immunocompetent patients generally develop a benign, self-limited mononucleosis-like syndrome whereas gastrointestinal tissue-invasive disease is more frequently seen in immunocompromised and inflammatory bowel disease patients. Additionally, liver allograft dysfunction is a significant consequence of CMV infection in liver transplant patients. While polymerase chain reaction and immunohistochemistry techniques allow for the reliable and accurate detection of CMV in the human host, the diagnostic value of different serologic, endoscopic, and histologic tests depends on a variety of factors. Similarly, latent CMV, CMV infection, and CMV disease carry different significance depending on the patient population, and the decision to initiate antiviral therapy can be complex and patient-specific. This review will focus on the pathophysiology, diagnosis, and management of CMV in patient populations relevant to the practice of gastroenterology and hepatology—liver transplant recipients, inflammatory bowel disease patients, and otherwise immunocompetent patients.

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Section: CMV In the General Population: Presentation Diagnosis Amentioning

confidence: 99%

A Practical Review of Cytomegalovirus in Gastroenterology and Hepatology

Fakhreddine

Frenette

Konijeti

2019

Gastroenterology Research and Practice

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“…Although clinically significant CMV infection is considered rare in immunocompetent individuals, there are multiple reports in literature highlighting that it should be considered in differential diagnoses [ [3] , [4] , [5] , [6] , [7] , [8] , [9] ]. Multiple organ systems can be affected by CMV, the most common being gastrointestinal tract with manifestations such as colitis, gastritis, gastric ulcer [ 10 , 11 ], hepatitis [ 12 ], pancreatitis [ [12] , [13] , [14] , [15] ], duodenitis, or enteritis. Other organ systems affected by CMV include central nervous system (meningitis, encephalitis, and transverse myelitis), hematological disorders (hemolytic anemia, thrombocytopenia), vascular thrombosis (venous thromboembolism, portal vein thrombosis), and ocular involvement (uveitis) and lung disease (pneumonitis).…”

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus pancreatitis in an immunocompetent patient

Saeed

Nwogbo

Gani

et al. 2020

IDCases

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Cytomegalovirus (CMV) is a double-stranded DNA virus, which infects a large portion of the adult population. In immunocompetent patients, it typically is asymptomatic or manifests as mild and self-limiting flu-like illness symptoms, whereas in immunocompromised patients, CMV can cause significant disease. Herein we report an unusual case of CMV pancreatitis in an immunocompetent 75-year-old female. Patient developed severe significant pancreatic necrosis that failed non-operative management, and ultimately underwent pancreatic necrosectomy. Later on, she developed three spontaneous gastric perforations. The first two perforations were managed operatively, but after the third perforation family decided not to undergo another operation. The CMV pancreatitis diagnosis was based on pancreatic histopathology and confirms by a prompt response to ganciclovir. Patient was promptly started on intravenous (IV) ganciclovir which resulted in clinical recovery and she remained asymptomatic more than one-year post op. This is a rare case of CMV pancreatitis with gastric perforations in an immunocompetent patient. High degree of suspicion and appropriate treatment are important for such clinical scenarios.

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“…Ve většině případů se IPP terapie ukázala být efektivním řešením (10,7). V některých případech byli pacienti léčeni ganciklovirem (8,9).…”

Section: Závěrunclassified

Rare manifestation of CMV infection - circular stenosis of the stomach

Hrabák¹,

Petrtýl²,

Sroubkova³

et al. 2020

Vnitř Lék

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Ústav patologie VFN a 1. LF UK v Praze 3 Radiodiagnostická klinika VFN a 1. LF UK v Praze V tomto článku popisujeme případ pacientky s bolestmi v epigastriu, u níž byl diagnostikován cirkulární stenózující vřed žaludku. Dalším vyšetřením byla zjištěna CMV etiologie. Po zahájení terapie inhibitory protonové pumpy a antivirové terapie došlo k úzdravě. Orgánová manifestace CMV infekce je poměrně častou komplikací u imunokompromitovaných pacientů. U imunokompetentních pacientů bývá orgánové postižení relativně vzácné. Přesto je však nutno i na tuto etiologii pomýšlet.

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Cytomegalovirus and the Seemingly Immunocompetent Host: A Case of a Perforating Gastric Ulcer

Cited by 5 publications

References 10 publications

A Practical Review of Cytomegalovirus in Gastroenterology and Hepatology

A Practical Review of Cytomegalovirus in Gastroenterology and Hepatology

Cytomegalovirus pancreatitis in an immunocompetent patient

Rare manifestation of CMV infection - circular stenosis of the stomach

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