title: Cytomegalovirus-induced massive small intestinal bleed. Case report and review of the literature.
abstract: We report a case of massive small intestinal bleeding in a non-HIV positive patient treated with cyclophosphamide and steroids for polyarteritis nodosa. Tagged red blood cell studies, endoscopy, and angiograms were performed prior to exploratory laparotomy. Jejunal ulceration and bleeding were evident by serosal staining. Resected segments revealed intracytoplasmic inclusions positive for cytomegalovirus by immunoperoxidase staining. A second bleed after the resection was controlled with oral norepinephrine, prior to effective therapy with ganciclovir.
authors.affiliation: Department of Surgery, University of Colorado Health Sciences Center, Denver.
authors.forename: J H
authors.initials: JH
authors.lastname: Sun
authors.forename: W S
authors.initials: WS
authors.lastname: Johnson
authors.forename: J F
authors.initials: JF
authors.lastname: Bascom
mesh_terms: D000208:Acute Disease; D003131:Combined Modality Therapy; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis / Q000628:therapy; D017809:Fatal Outcome; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007579:Jejunal Diseases / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D008297:Male; D008875:Middle Aged; D014456:Ulcer / Q000150:complications* / Q000175:diagnosis / Q000209:etiology / Q000628:therapy