Recurrent cytomegalovirus colitis with megacolon in an immunocompetent elderly man

Lin, Yi‐Hsuan; Yeh, Chi-Ju; Chen, Ying-Jen; Chang, Ming‐Chu; Su, I-Hao; Cheng, Hao‐Tsai

doi:10.1002/jmv.21712

Cited by 20 publications

(10 citation statements)

References 19 publications

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“…Five of these six patients but only 2 of the 40 patients without HCMV infection had TM [4]. Further cases reports described the association between HCMV and TM [5][6][7] but it is not clear if HCMV is more frequent in TM than in severe colitis. …”

Section: Introductionmentioning

confidence: 99%

Toxic megacolon and human Cytomegalovirus in a series of severe ulcerative colitis patients

Criscuoli

Rizzuto

Gallo

et al. 2015

Journal of Clinical Virology

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a b s t r a c tBackground: Human Cytomegalovirus (HCMV) infection has been reported to be a cause of refractory ulcerative colitis (UC). Toxic megacolon (TM) is a rare but severe complication of an acute attack of UC. Objectives: Aim of this study is to evaluate in a case-control study the association between HCMV and TM. Study design: All patients who were admitted at Medicine Department of V. Cervello Hospital in Palermo (tertiary referral center) for a severe UC flare-up complicated by the onset of TM (diameter of the transverse colon > 6 cm) between January 1990 and November 2011 were identified through the electronic database. A total of 24 consecutive patients (16 male/8 female) with TM were identified. Each case of TM were individually matched by sex, age, extent of the underlying disease to 24 severe UC controls who did not develop TM. A further non matched control population of 48 severe UC was included.Haematoxilin and eosin stain, immunohistochemical procedure and nested polymerase chain reaction were performed to detect HCMV genes and proteins on rectal biopsies or surgical specimens. Pp65 antigenemia was performed in order to diagnose any possible systemic infection. HCMV frequency was compared between patients with and without TM during follow-up, using Fisher's Exact test. Results and conclusions: HCMV was detected in histological specimens of 11 patients (46%) with TM compared to 2 (9%) severe UC matched controls (P = 0.0078) and 7 (14%) unmatched controls (p = 0,003). In severe colitis the presence of HCMV is more frequently associated with TM.

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Section: Introductionmentioning

confidence: 99%

Toxic megacolon and human Cytomegalovirus in a series of severe ulcerative colitis patients

Criscuoli

Rizzuto

Gallo

et al. 2015

Journal of Clinical Virology

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“…Bu nedenle antiviral kullanılıp kullanılmayacağı, hastalığın şiddetine göre bireysel olarak değerlendirilmeli ve ilaçların olası yan etkileri de düşünülerek karar verilmelidir. İleri yaş olgularda mevcut immün yanıtın zayıflığı ve sahip oldukları komorbiditelerin çokluğu düşünüldüğünde antiviral tedavi gereksinimi gençlere göre daha fazla olabilmektedir [14,15] . İkinci olgu diğerlerinden daha ileri yaşta olup daha ağır klinik ile seyretmiş ve antiviral tedavi verilmiştir.…”

Section: Discussionunclassified

Cytomegalovirus Disease Causing Outbreak in Family Members

Pullukçu¹,

Başkol²,

Zeytinoğlu³

et al. 2019

FLORA

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Daha çok genç erişkin ve adölesanlarda asemptomatik olan, bazen de ateş, farenjit ile sitomegalovirüs (CMV) mononükleozu şeklinde görülen bu infeksiyon orta ve ileri yaşta nadiren akut infeksiyon şeklinde görülmektedir. Kliniğimize yaklaşık bir ay arayla ateş yakınmasıyla başvuran aynı aileden üç orta yaş erişkinde akut CMV infeksiyonu saptanmıştır. Olguların ikisi ateş etyolojisi araştırılması için yatırılmış, üçüncü olguda aile öyküsü nedeniyle daha konservatif yaklaşılmıştır. Orta yaşlarda bireylere sahip bir ailede, aile içi CMV salgını literatüre bakıldığında çok az görülmektedir. Bu yazıda yukarıda belirtilen açıdan CMV hastalığı tartışılmıştır.

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“…Perforation is the most lethal complication and is commonly seen between ileum and splenic flexure [8,16]. Other rare complications are toxic megacolon [17] and acute appendicitis [16]. …”

Section: Discussionmentioning

confidence: 99%

Small bowel perforation due to CMV enteritis infection in an HIV-positive patient

et al. 2013

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BackgroundCytomegalovirus infection of the gastrointestinal tract is common and is more often seen in patients with acquired immunodeficiency syndrome (AIDS). Although small bowel infection is less common than infection of other parts of the gastrointestinal system, it may lead to perforation, an acute complication, with dreadful results.Case presentationThis article reports a case of Cytomegalovirus ileitis with multiple small bowel perforations in a young man with human immunodeficiency virus (HIV) infection. The patient developed abdominal pain with diarrhea and fever, and eventually acute abdomen with pneumoperitoneum. The patient had poor prognosis and deceased despite the prompt surgical intervention and the antiviral therapy he received. At pathology a remarkable finding was the presence of viral inclusions in smooth muscle fibers. The destruction of muscle cells was the main cause of perforation.ConclusionMorbidity and mortality associated with perforation from CMV enteritis in AIDS patients are high and the life expectancy is short. Cytomegalovirus disease is multifocal; therefore, excision of one portion of the gastrointestinal tract may be followed by a complication elsewhere. Our case elucidate that muscle cell destruction by the virus is a significant cause leading to perforation.

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Recurrent cytomegalovirus colitis with megacolon in an immunocompetent elderly man

Cited by 20 publications

References 19 publications

Toxic megacolon and human Cytomegalovirus in a series of severe ulcerative colitis patients

Toxic megacolon and human Cytomegalovirus in a series of severe ulcerative colitis patients

Cytomegalovirus Disease Causing Outbreak in Family Members

Small bowel perforation due to CMV enteritis infection in an HIV-positive patient

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