Cytomegalovirus-associated protracted diarrhoea in an immunocompetent boy.
OBJECTIVE
Cytomegalvirus (CMV) gastroenteritis is rarely described in immunocompetent children. We describe here an immunocompetent 1-year-old boy with CMV-associated protracted diarrhoea and discuss the pathogenesis of CMV infection of the gastrointestinal tract.


METHODS
Immunohistochemical study was performed using a gastric and duodenal tissue of this patient. Furthermore, the detection of CMV-DNA in stool and urine samples was performed by polymerase chain reaction method.


RESULTS
CMV infection was proven by the detection of CMV-DNA in stool and urine samples and CMV-positive cells in the immunoperoxidase preparation from gastroduodenal biopsy. The biopsy specimens showed severe chronic active gastroduodenitis with numerous CD3+ T cells and CD68+ macrophages.


CONCLUSIONS
We speculated from these findings that CMV invasion of the mucosal layer induced an intense immune response characterised by massive infiltration of activated T-cells and macrophages in this patient. Although the pathogenesis of CMV-associated gastroenteritis in immunocompetent hosts remains generally unknown, immune mechanism may play some roles in generating the chronic inflammatory lesions.
Shimizu
Masaki
M
Department of Pediatrics, Graduate School of Medical Science, Kanazawa University, Ishikawa, Japan. mshimizu@ped.m.kanazawa-u.ac.jp
Ohta
Kazuhide
K
Wada
Hideo
H
Sumita
Ryo
R
Yachie
Akihiro
A
Koizumi
Shoichi
S
D015703:Antigens, CD / Q000378:metabolism; D015214:Antigens, Differentiation, Myelomonocytic / Q000378:metabolism; D001706:Biopsy; D017252:CD3 Complex / Q000378:metabolism; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000276:immunology; D003968:Diarrhea, Infantile / Q000209:etiology* / Q000276:immunology / Q000628:therapy*; D005759:Gastroenteritis / Q000276:immunology / Q000821:virology*; D041981:Gastrointestinal Tract / Q000276:immunology / Q000473:pathology / Q000821:virology; D006801:Humans; D007121:Immunocompetence; D007223:Infant; D017737:Macrophages, Peritoneal / Q000276:immunology; D000097382:CD68 Molecule
D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D017252:CD3 Complex; C067980:CD68 antigen, human; D000097382:CD68 Molecule