[Cytomegalovirus colitis in an elderly polytraumatised patient].
METHODS
During a long-term stay on a intensive-care unit a polytraumatised elderly patient developed hematochezia, which was refractory to blood transfusion.


METHODS
During colonoscopy, multiple ulcers were found in the right colon and rectum, and right hemicolectomy was performed after another massive anal blood loss. Histological findings showed characteristic intranuclear inclusions, positive Cytomegalovirus (CMV)-IgM titer and positive polymerase chain reaction (PCR) in blood.


METHODS
After hemicolectomy, antiviral therapy with ganciclovir was initiated for two weeks intravenously, and no more gastrointestinal symptoms occurred. In the following days, enteral alimentation was continued without problems.


CONCLUSIONS
CMV colitis should be considered in immunoincompetent patients after more common etiologies for severe diarrhea have been excluded. Timely diagnosis is essential to improve the outcome for elderly patients or patients with severe co-morbidities.
Wildenauer
R
R
Klinik für Unfallchirurgie, Universitätsklinikum Essen. wildenauer@foni.net
Suttorp
A-C
AC
Kobbe
P
P
D000063:Accidents, Traffic; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000188:drug therapy / Q000821:virology; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy; D006801:Humans; D007869:Leg Injuries / Q000150:complications; D009104:Multiple Trauma / Q000150:complications*; D010384:Pelvic Bones / Q000293:injuries; D013898:Thoracic Injuries / Q000150:complications
D000998:Antiviral Agents; D015774:Ganciclovir