ABSTRACT
Cytomegalovirus(CMV) disease is a major cause of morbidity and mortality in immunocompromised patients. CMV enteritis should be considered when nausea and vomiting continue 3 to 4 weeks after bone marrow transplantation(BMT). The treatment of CMV enteritis is not well established. We report a CMV duodenitis patient following allogenic bone marrow transplantation. The patient had prolonged nausea and vomiting for 5 weeks after bone marrow transplantation and CMV duodenitis was diagnosed by the gastroduodenoscopic mucosal biopsy which showed cytomegalic cells. Ganciclovir treatment for 3 weeks resulted in the resolution of symptoms and promoted healing of the lesion. The patient was free of CMV infection until 288 days after allogenic BMT without maintenance ganciclovir treatment.
Subject(s)
Adult , Humans , Male , Antiviral Agents/therapeutic use , Bone Marrow Transplantation/adverse effects , Cytomegalovirus Infections/etiology , Cytomegalovirus Infections/drug therapy , Cytomegalovirus Infections/diagnosis , Duodenitis/etiology , Duodenitis/drug therapy , Duodenitis/diagnosis , Ganciclovir/therapeutic use , Transplantation, HomologousABSTRACT
Ciento diecinueve niños de uno a 14 años que consultaron por síntomas sugestivos de enfermedad ácido péptica (EAP) fueron estudiados con endoscopia y biopsia. Presentaron gastritis antral 73.1 por ciento, duodenitis 10.08 por ciento, úlcera duodenal 4.2 por ciento, úlcera gástrica 1.6 por ciento y esofagitis 0.8 por ciento. Cincuenta y un pacientes fueron positivos para H.pylori. Tanto el grupo positivo como el negativo tuvieron sintomatología similar, pero la úlcera duodenal se asoció significativamente a H.pylori. Veintinueve (87.8 por ciento) de 33 niños positivos mejoraron clínicamente con diferentes combinaciones de amoxacilina, metronidazol, bismuto y antiácidos y antagonistas H2. Veinticinco (95 por ciento) de 26 negativos mejoraron con antiácidos y antagonistas H2
Subject(s)
Humans , Child , Duodenitis/classification , Duodenitis/diagnosis , Duodenitis/drug therapy , Duodenitis/etiology , Esophagitis/classification , Esophagitis/diagnosis , Esophagitis/drug therapy , Esophagitis/etiology , Gastritis/diagnosis , Gastritis/drug therapy , Gastritis/etiology , Gastritis/nursing , Stomach Ulcer/classification , Stomach Ulcer/diagnosis , Stomach Ulcer/etiology , Stomach Ulcer/drug therapy , Helicobacter pylori/classification , Helicobacter pylori/growth & development , Helicobacter pylori/isolation & purification , Helicobacter pylori/pathogenicityABSTRACT
The effect of colloidal bismuth subcitrate (De-Nol) on symptoms, Helicobacter pylori status and histological features was studied in 35 patients with non-ulcer dyspepsia. Pain (34 cases) and gas bloat (18) were the predominant symptoms. H pylori was present in 26 (74.3%) patients. Gastritis and duodenitis were present in 29 of 32 and 22 of 31 cases respectively in whom biopsies were available. Relief in symptoms after treatment was seen in 29 (82.8%) cases. Improvement in gastritis and duodenitis was noted in 60.8% and 58.8% respectively; over 70% of H pylori positive patients cleared the organism. These changes did not correlate with the relief in symptoms. We conclude that colloidal bismuth subcitrate is effective in the short term treatment of non-ulcer dyspepsia. It also clears H pylori infection and results in improvement of histological features.