Surgical manifestations of gastrointestinal cytomegalovirus infection in children: Clinical audit and literature review

Cytomegalovirus Infection of the Gastrointestinal Tract in Soweto, South Africa: A Look Back at the Clinical and Histological Features over 8 Years

“…There could be cases at this hospital that were not biopsied at time of endoscopy. Symptoms were similar to those reported elsewhere [7,8,17]. Dysphagia, abdominal pain, loss of weight and diarrhoea are more frequent in patients with CMV compared to other infections [18].…”

“…Two thirds of patients who were tested had CD4 counts < 50/mm 3 in keeping with another study [16]. Fewer paediatric cases were noted compared to another South African study [7]. This may reflect regional differences in management practices.…”

“…Mortality was high (27.7%) and predominantly in HIV infected patients with low CD4 counts, but attribution solely to CMV disease was not always clear. A mortality rate of 32% in a paediatric cohort was reported, half of all deaths occurred within one month [7]. Decreased mortality is achieved with improved body weight, higher CD4 counts, higher hemoglobin levels and lower viral loads, all attainable by ART usage [14].…”

“…We found Cryptosporidium and Helicobacter to be the commonest co-pathogens. Other co-infecting pathogens that have been described include Mycobacterium (M. avium), adenovirus, Entamoeba and candidiasis [7,18,21]. One of these studies [18] found co-infection with CMV in 37% of cases.…”

“…Fourteen percent of HIV-infected adults with abdominal pain had CMV disease [6]. Of the 38 children with GIT CMV disease 55% were HIV infected and oesophageal and small bowel disease were commonest [7]. GIT symptoms, abnormalities on endoscopy and histological detection of CMV infection in a GIT biopsy specimen are required to diagnose CMV GIT disease.…”