Cytomegalovirus colitis mimicking ischemic colitis in an immunocompetent host

Siegal, Daniel; Hamid, Naveed S.; Cunha, Burke A.

doi:10.1016/j.hrtlng.2004.08.009

Cited by 49 publications

(39 citation statements)

References 15 publications

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“…Studies show valganciclovir is as effective as ganciclovir in prophylaxis and treatment of CMV disease in high-risk solid organ transplant recipients and in treatment of AIDS-related CMV retinitis 7–9. In the literature there are two reports of use of valganciclovir in the successful treatment of immunocompetent patients with gastrointestinal manifestations of CMV infection,10 11 and one report of CMV myopericarditis and hepatitis which rapidly responded to valganciclovir in an immunocompetent adult 12…”

Section: Discussionmentioning

confidence: 99%

Valganciclovir treatment of primary cytomegalovirus pneumonitis in an immunocompetent adult

Snape

Venkatesan²

2011

Case Reports

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Section: Discussionmentioning

confidence: 99%

Valganciclovir treatment of primary cytomegalovirus pneumonitis in an immunocompetent adult

Snape

Venkatesan²

2011

Case Reports

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“…Thus the diagnosis of CMV colitis might be complicated as it may mimic the symptoms of other diseases. CMV colitis can be confused with ischemic colitis when an elderly patient presents with bloody diarrhea and abdominal pain (11). In our patient, other types of colitis (such as ischemic colitis, collagenous colitis or ulcerative colitis) were also suspected.…”

Section: Discussionmentioning

confidence: 66%

Cytomegalovirus Colitis in a Critically Ill Patient Following Severe <i>Legionella</i> Pneumonia with Multiple Organ Failure

et al. 2016

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A 68-year-old man visited an emergency department complaining of dyspnea. He was diagnosed to have Legionella pneumonia with multiple organ failure. Although his multiple organ failure improved, he suffered from persistent abdominal pain and diarrhea with continuous minor bleeding. Colonoscopy revealed a longitudinal ulcer of the rectum, below the peritoneal reflection. He was diagnosed with cytomegalovirus (CMV) colitis. Antiviral therapy with ganciclovir was initiated. He finally underwent a colostomy after a bowel stricture caused an intestinal outlet obstruction, which made oral intake impossible. Based on the present case, we believe that CMV colitis must be considered as one of the differential diagnoses when critically ill patients develop continuous diarrhea and abdominal pain.

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“…[8] Diagnosis is difficult to make and mostly delayed, mainly because CMV enteritis has the ability to mimic many diseases, such as ischemia, inflammatory bowel diseases, colitis caused by C. difficile. [9,10] The diagnosis can be confirmed by performing histology on biopsies of the terminal ileum. [11] Serological tests, such as CMV IgM, IgG antibodies and CMV viral load testing were done in this case and showed a low IgG and slightly elevated IgM.…”

Section: Discussionmentioning

confidence: 99%

A rare case of cytomegalovirus presentation in a hemodialysis patient

Waele

Wierckx

Bogaert³

2017

CRIM

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Background: Cytomegalovirus (CMV) infection is a common viral infection in humans with a diverse manifestation, mostly dependent on the host. CMV infection in the immunocompetent host is generally asymptomatic or may present as a mononucleosis syndrome. Infection in immunocompromised patients cause substantial morbidity and mortality. Case representation: We report a rare manifestation of a CMV infection in a 87-year-old male with end-stage renal failure with dialysis dependency and diabetes who presents with diffuse abdominal pain and nausea. Further assessment with a CT scan of the abdomen showed a thickening of the wall of the preterminal ileum, suggestive of focal enteritis. Ileocolonoscopy showed a partial circular ulcerated mucosa of the preterminal ileum, biopsies showed ulcerations, etiology was unknown. A few days later he develops melena and anemia of 7.2 g/dl. Further exploration with gastroscopy was normal. A new colonoscopy showed no abnormalities; however the terminal ileum could not be visualized. An urgent laparotomy was performed because of hemodynamic instability and showed an ulcus of 7 cm with a thickened terminal ileum. An enterectomy of the inflammated part of the ileum was performed. Histopathology of the ulceration showed the presence of CMV inclusions in the vascular endothelium of the capillaires of the ileal segment. Serologic examination showed nonreactive CMV IgM antibodies and IgG antibodies were positive. PCR CMV showed 300 copies/ml (whole blood). Treatment with intravenous ganciclovir was started with good clinical and biochemical response. Conclusions: In the differential diagnosis CMV disease should be considered in any ulceration in the gastro-intestinal tract in the immunocompromised patient.

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Cytomegalovirus colitis mimicking ischemic colitis in an immunocompetent host

Cited by 49 publications

References 15 publications

Valganciclovir treatment of primary cytomegalovirus pneumonitis in an immunocompetent adult

Valganciclovir treatment of primary cytomegalovirus pneumonitis in an immunocompetent adult

Cytomegalovirus Colitis in a Critically Ill Patient Following Severe <i>Legionella</i> Pneumonia with Multiple Organ Failure

A rare case of cytomegalovirus presentation in a hemodialysis patient

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