Cytomegalovirus Colitis with a Cobblestone Appearance

Abstract

Cytomegalovirus (CMV) colitis with a cobblestone appearance is rare, and its endoscopic and pathological features remain poorly described. A 78-year-old woman was admitted to our hospital for disturbance of consciousness, high-grade fever, and diarrhea occurring up to 7 times a day. Sigmoidoscopy revealed a circumferential ulcer with mucosal defect, an ulcer with a cobblestone appearance extending from the upper rectum to the sigmoid colon, and an irregular ulcer on the lower rectum. She was histopathologically diagnosed with CMV colitis and intravenously treated with ganciclovir (5 mg/kg) for 7 weeks. Colonoscopy after treatment revealed an improvement of the ulcers extending from the rectum to the sigmoid colon, but no significant improvement of her general condition. She died from sepsis 4 months after hospitalization. To our knowledge, this report represents a valuable addition to the CMV literature describing a rare case of CMV colitis with a cobblestone appearance.

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

“…Several case reports show CMV can cause single‐organ damage even in patients with intact immunity 31 . Based on previous studies, CMV colitis can occur in immunocompetent and immunocompromised and IBD patients 32 …”

“…31 Based on previous studies, CMV colitis can occur in immunocompetent and immunocompromised and IBD patients. 32 Although we discovered that CMV colitis and intestine inflammation can happen in patients with impacted immune systems, it is still uncertain if these patients are immunocompetent. Many patients had advanced age and long-lasting health problems such as diabetes and chronic kidney disease.…”

“… 31 Based on previous studies, CMV colitis can occur in immunocompetent and immunocompromised and IBD patients. 32 …”