Massive lower gastrointestinal hemorrhage caused by CMV disease as a presentation of HIV in an infant.
The gastrointestinal (GI) manifestations of acquired immunodeficiency syndrome in children are related to opportunistic infections like cytomegalovirus (CMV). CMV disease of the GI tract is a major cause of morbidity and mortality in immunocompromised patients: it typically produces mucosal ulcerations that can result in pain, bleeding, diarrhea, and GI perforation, often around the cecum. Preoperative diagnosis may be difficult, plain films and barium enema are often non-specific, and endoscopic evaluation is impossible when there is massive bleeding. The patient usually needs surgery to establish the correct diagnosis and initiate appropriate treatment. The use of gancyclovir for CMV disease in the postoperative period has improved the prognosis.
Zanolla
G
G
Department of Paediatric Surgery, University Hospital of Santa Maria, Rio Grande do Sul, Brazil.
Resener
T
T
Knebel
R
R
Verney
Y
Y
D003108:Colonic Diseases / Q000473:pathology / Q000821:virology*; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000473:pathology; D017809:Fatal Outcome; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000517:prevention & control / Q000821:virology*; D015658:HIV Infections / Q000150:complications* / Q000473:pathology; D006801:Humans; D007223:Infant; D009102:Multiple Organ Failure / Q000209:etiology