RESUMEN
Cytomegalovirus (CMV) infection is a common human viral infection, affecting 40% to 100% of normal adult, especially in the immune compromised patients. CMV infection can produce variable gastrointestinal (GI) diseases in healthy adults, but can cause severe life-threatening illness involving many organs, including lung, retina, central nervous system, liver and GI tract in immunocompromised host. We experienced CMV colitis with colon perforation in a SLE patient during low dose steroid and azathioprine therapy, and she recovered after medical treatment without surgical interventions. A 33-year-old woman was diagnosed as SLE 7 years ago and treated with low dose, immunosuppressive therapy during 6 years. She complained of a severe abdominal pain and hematochezia. She was diagnosed as CMV colitis with colon perforation by pathologic, immunologic and image studies. After medical treatment, such as intravascular ganciclovir, there was progressive medical improvement, but has been a recurrent CMV colitis with lower GI bleeding.
Asunto(s)
Adulto , Femenino , Humanos , Dolor Abdominal , Azatioprina , Sistema Nervioso Central , Colitis , Colon , Citomegalovirus , Ganciclovir , Hemorragia Gastrointestinal , Tracto Gastrointestinal , Hemorragia , Huésped Inmunocomprometido , Hígado , Pulmón , Lupus Eritematoso Sistémico , RetinaRESUMEN
Cytomegalovirus (CMV) is the most common cause of life-threatening opportunistic viral infection in patients with acquired immunodeficiency syndrome (AIDS). However, CMV infection may occur in the immunocompetent individuals. CMV colitis has not been reported in a patient with splenectomy in Korea. Recently, we experienced a case of fatal CMV colitis in a patient with splenectomy. A 69-year-old man complained of bloody mucoid diarrhea and abdominal pain for 2 months. He had the splenectomy 6 months ago. CMV colitis was diagnosed by colonoscopy and pathologic examination. He died of sepsis in spite of antiviral ganciclovir therapy.
Asunto(s)
Anciano , Humanos , Dolor Abdominal , Síndrome de Inmunodeficiencia Adquirida , Colitis , Colonoscopía , Citomegalovirus , Diarrea , Ganciclovir , Corea (Geográfico) , Sepsis , EsplenectomíaRESUMEN
Cytomegalovirus (CMV) colitis occurs almost exclusively in immune-compromised patients namely, HIV infection, immunosuppressant therapy after organ transplantation, anti-cancer chemotherapy, and long- term steroid user. Some patients with solid tumor have gastrointestinal CMV disease without anti-cancer chemotherapy. A 64-year-old male patient underwent surgery due to sigmoid colon cancer. On histopathologic examination of surgical specimen, CMV colitis was found in the colon. The AJCC tumor stage was II. Although CMV colitis is rarely associated with colon cancer, it maybe considered in patients with combined colitis with colorectal cancer.
Asunto(s)
Humanos , Masculino , Persona de Mediana Edad , Adenocarcinoma , Colitis , Colon , Neoplasias del Colon , Neoplasias Colorrectales , Citomegalovirus , Quimioterapia , Infecciones por VIH , Trasplante de Órganos , Neoplasias del Colon Sigmoide , TrasplantesRESUMEN
Cytomegalovirus (CMV) disease in gastrointestinal tract is common among immunocompromised host. Ulcer, hemorrhage and perforation are manifestations of CMV infection in gastrointestinal tract and the most common site of intestinal perforation is the colon, followed by the distal ileum. Early diagnosis and preemptive therapy of CMV infection in the gastrointestinal tract should be warranted to prevent intestinal perforation, one of life-threatening complications of CMV colitis. We report a case of CMV colitis leading to colonic perforation in a patient with non-Hodgkin's lymphoma (T/NK cell lymphoma). Immunohistochemical stain of surgical specimen revealed positive, followed by positive EA-IPA and PCR for CMV antigen. He survived after successful left hemicolectomy and intravenous ganciclovir therapy.