Cytomegalovirus colitis mimics amebic colitis in a man with AIDS.
Opportunistic gastrointestinal infections are common in patients with HIV infection; both amebic colitis and cytomegalovirus (CMV) colitis are common causes of chronic diarrhea. It is difficult to distinguish these 2 diseases by nonspecific clinical symptoms such as diarrhea, abdominal pain, and weight loss. Here we report a case of CMV colitis mimicking amebic colitis with elevated indirect hemagglutination assay antibody titer against Entamoeba histolytica and negative IgM antibody titer against CMV. The diagnosis of CMV colitis was confirmed by eosinophilic nucleoli and inclusion bodies in colon biopsies. The patient recovered after ganciclovir and highly active antiretroviral therapy. Exact diagnoses are important for treating opportunistic infections. Other pathogens should be considered in patients with chronic diarrhea who are refractory to initial treatments. Our case highlights the importance of histopathological diagnosis for chronic diarrhea in patients with HIV infection and the possibility of false-positive results for indirect hemagglutination assay antibody against Entamoeba histolytica despite high titers.
Division of Infectious Disease and Tropical Medicine, Department of Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
Yung-Chih
YC
Wang
Herng-Sheng
HS
Lee
Te-Yu
TY
Lin
Ning-Chi
NC
Wang
D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000188:drug therapy; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D003092:Colitis / Q000175:diagnosis*; D003106:Colon / Q000473:pathology / Q000821:virology; D003587:Cytomegalovirus / Q000187:drug effects; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy; D003937:Diagnosis, Differential; D004404:Dysentery, Amebic / Q000175:diagnosis*; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged
D000998:Antiviral Agents; D015774:Ganciclovir