Cytomegalovirus colitis

Hashash, Jana G.; Refaat, Marwan; Abdulbaki, Abdulrahman; Aoun, Elie; Baidoo, Leonard

doi:10.3949/ccjm.78a.11028

Cited by 4 publications

(10 citation statements)

References 4 publications

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“…Colitis remission rates after anti‐viral treatment in IBD patients with CMV infection range from 67% to 100% (Table ) . When the full course of anti‐viral therapy is completed, immunosuppressant therapies including thiopurines may be safely re‐commenced.…”

Section: Treatment Of CMV Colitismentioning

confidence: 99%

“…It is the first line treatment for CMV infection which is given intravenously, at a dose of 5 mg/kg, twice per day, initially. If there is a clinical response then it may be switched to oral therapy; however, some authors advocate a full 14 day course of intravenous treatment . Valganciclovir, the pro‐drug of ganciclovir, has superior oral absorption and may be preferred for out‐patient management, although most patients requiring therapy will be in‐patients.…”

Section: Treatment Of CMV Colitismentioning

confidence: 99%

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Review article: cytomegalovirus and inflammatory bowel disease

Sager

Alam

Bond

et al. 2015

Aliment Pharmacol Ther

136

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Summary Background The association between ulcerative colitis and cytomegalovirus (CMV) has been recognised for over 50 years; and the role of CMV in ulcerative colitis in general, and steroid resistance in particular, remains a topic of ongoing controversy. The outcome for patients with CMV reactivation appears worse than that for patients without reactivation, but it is not entirely clear whether CMV is a contributor or a bystander and if treatment with anti‐virals alters the course of inflammatory bowel disease (IBD). Aim To review the role of CMV associated with IBD, including epidemiology, clinical features, diagnosis and management strategies. Methods By reviewing literature available on CMV associated with IBD in adult patients. A PubMed literature search was performed using the following terms individually or in combination: CMV colitis, cytomegalovirus colitis, IBD and CMV, CMV treatment. Results Cytomegalovirus reactivation is common in patients with severe colitis, with a reported prevalence of 4.5–16.6%, and as high as 25% in patients requiring colectomy for severe colitis. The outcome for this group of patients appears worse than that for patients without reactivation; however, reported remission rates following treatment with anti‐viral therapy are as high as 71–86%. Conclusions Evidence, although not conclusive, supports testing for CMV colonic disease in cases of moderate to severe colitis, by processing biopsies for haematoxylin and eosin staining with immunohistochemistry and/or, CMV DNA real‐time polymerase chain reaction; and if present treating with ganciclovir.

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Section: Treatment Of CMV Colitismentioning

confidence: 99%

Section: Treatment Of CMV Colitismentioning

confidence: 99%

Review article: cytomegalovirus and inflammatory bowel disease

Sager

Alam

Bond

et al. 2015

Aliment Pharmacol Ther

136

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“…Common end organ disorders caused by CMV in immunocompromised patients include hepatitis which can lead to fulminant liver failure, retinitis especially in HIVpositive patients, colitis and esophagitis as the first and second most common gastrointestinal tract manifestation of CMV, pneumonitis, especially in hematopoietic stem cell transplant recipients, rarely transverse myelitis, and even encephalitis with poor prognosis. [8][9][10][11][12][13][14] CMV colitis usually occurs in immunocompromised patients and is prevalent from 21% to 34% worldwide. The symptoms of CMV colitis are very similar to inflammatory bowel disease (IBD) colitis exacerbation.…”

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confidence: 99%

“…Therefore, ganciclovir is given to prevent future severe complications. 9,17 According to the literature review, we expect to see CMV colitis in immunocompromised patients, but there were several immunocompetent hosts with the same condition. In this article, we have described a case of CMV colitis in an immunocompetent host and have described the diagnostic approach, management, and clinical course in such cases.…”

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confidence: 99%

Cytomegalovirus colitis in immunocompetent hosts: A case report and literature review

Salehi,

Shafiee,

Moradi

2024

Clinical Case Reports

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Key Clinical MessageRectal bleeding can manifest cytomegalovirus (CMV) colitis even in immunocompetent patients, which can be cured with ganciclovir treatment.AbstractCytomegalovirus (CMV) is an opportunistic virus widely affecting immunocompromised patients. Different manifestations varied from asymptomatic in immunocompetent individuals to end organ involvement, such as colitis in those with immunodeficiency. Despite the rarity of CMV colitis in immunocompetent hosts, we should consider it when the other conditions have been excluded. In this article, we have described a case of CMV colitis in an immunocompetent host and have performed a literature review on this entity. An immunocompetent 70‐year‐old female was admitted to the hospital with recurrent rectal bleeding. After various evaluations including laboratory analysis, stool examination, and colonoscopy, we have detected superficial lesions. Pathology and polymerase chain reaction reports favored CMV involvement. Her condition continues to improve after intravenous ganciclovir infusion. Rectal bleeding can manifest CMV colitis even in immunocompetent patients, which can be cured with ganciclovir treatment.

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A 36-year-old woman was admitted to our clinic with 1-week durated rectal bleeding and diarrhea 8 to 10 times a day.

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confidence: 99%

A case of newly diagnosed ulcerative colitis presenting with pseudo-membranous enterocolitis followed by CMV colitis complicated with rupture of mitral corda tendinea

Yozgat

Demirci

Altınbaş

et al. 2015

Int J Colorectal Dis

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Dear Editor:The incidence of superinfection of Clostridium difficile (C. difficiele) and cytomegalovirus (CMV)-related colitis in ulcerative colitis (UC) were reported as 1.8-4.6 % and 5-36 %, respectively [1][2][3]. Here, we try to present an UC patients presented with C. difficile and then CMV infection, but complicated with an unusual situation, corda tendinea rupture (CTR) in mitral valve.A 36-year-old woman was admitted to our clinic with 1-week durated rectal bleeding and diarrhea 8 to 10 times a day. Physical examination was in normal range. Hb level was 12 gr/dL, sedimentation rate 22 mm/Hg, and C-reactive protein 22 mg/L. Stool culture did not reveal any bacterial infection and C. difficile toxin A and Entamoeba hystolytica antigen in stool were negative. After the diagnosis of UC was taken, mesalazin 4000 mg/day was started. Recurrent fever reaching 38.3°C appeared at the 3rd day of therapy. Even with wide investigation, a source of infection cannot be defined. Therefore, prednisolone was started in the diagnosis of severe UC at the 7th day of therapy. At the 5th day of prednisolone treatment, second colonoscopy determined yellowish white plaques within 5 to 20-mm diameter. Prednisolone was stopped immediately and oral vancomycin was initiated. At the next day, a sudden shortness of breath and tachycardia appeared. The patient underwent immediate mitral valve repair surgery due to the findings of new TTE, a rupture of mitral corda tendinea. Then after, CMV DNA viral load was found as 269 copy/mL, and because of ongoing fever, intravenous ganciclovir was started even the lack of evidence of CMV infection in histopathologic evaluation of colonoscopy. In the upcoming days, both fever and bloody diarrhea were resolved, and the control colonoscopic examination revealed healed colonic mucosa. References

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Cytomegalovirus colitis

Cited by 4 publications

References 4 publications

Review article: cytomegalovirus and inflammatory bowel disease

Review article: cytomegalovirus and inflammatory bowel disease

Cytomegalovirus colitis in immunocompetent hosts: A case report and literature review

A case of newly diagnosed ulcerative colitis presenting with pseudo-membranous enterocolitis followed by CMV colitis complicated with rupture of mitral corda tendinea

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