title: Cytomegalovirus enterocolitis in apparently immunocompetent hosts: evaluation of the radiologic findings and clinical features.
abstract: OBJECTIVE
  To describe the clinical and radiologic features of cytomegalovirus (CMV) enterocolitis in apparently immunocompetent hosts.
  
  
  METHODS
  Our institutional review board approved this retrospective study, and informed consent was waived. Twelve apparently immunocompetent patients (7 women and 5 men; mean age, 58 years) with pathologically proven CMV enterocolitis were included. Computed tomographic (CT) scans were retrospectively reviewed to determine the extent and the location of mural thickening, maximal mural thickness, enhancement pattern, that is, single-halo, double-halo, and homogeneous patterns, and ascites.
  
  
  RESULTS
  Eight patients had comorbidities potentially affecting the host immune status, whereas 4 patients were apparently healthy before presentation. On CT, all patients showed mural thickening (range, 4-11 mm) involving the colon (n = 8), the small bowel (n = 1), or both (n = 3). Segmental involvement was most common (n = 9 for colon and n = 2 for small bowel), whereas focal involvement of the rectum (n = 1) and diffuse involvement of the entire ileum (n = 1) or the entire small bowel and colon (n = 1) were also noted. Colonic lesions showed variable enhancement patterns, including the single-halo (n = 6), homogeneous (n = 3), and double-halo patterns (n = 2), whereas all small-bowel lesions in 4 patients exhibited a single-ring pattern. Ascites was present in 7 patients. Complications requiring surgery occurred in 3 patients and included refractory bleeding (n = 2) and bowel perforation (n = 1).
  
  
  CONCLUSIONS
  Cytomegalovirus enterocolitis in immunocompetent hosts typically develops in elderly subjects with comorbidities, although it may also affect relatively young and healthy subjects. On CT, it is characterized by mild mural thickening of the small bowel and the colon and frequently shows segmental involvement and a single-halo enhancement pattern.
authors.affiliation: Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Eun Young
authors.initials: EY
authors.lastname: Chae
authors.forename: Seung Soo
authors.initials: SS
authors.lastname: Lee
authors.forename: Jun-Won
authors.initials: JW
authors.lastname: Chung
authors.forename: Hyun Jin
authors.initials: HJ
authors.lastname: Kim
authors.forename: Seong Ho
authors.initials: SH
authors.lastname: Park
authors.forename: Ah Young
authors.initials: AY
authors.lastname: Kim
authors.forename: Hyun Kwon
authors.initials: HK
authors.lastname: Ha
mesh_terms: D000328:Adult; D000368:Aged; D003113:Colonoscopy; D015897:Comorbidity; D003287:Contrast Media; D003586:Cytomegalovirus Infections / Q000000981:diagnostic imaging* / Q000276:immunology / Q000473:pathology / Q000628:therapy; D004760:Enterocolitis / Q000000981:diagnostic imaging* / Q000276:immunology / Q000628:therapy / Q000821:virology*; D005260:Female; D006801:Humans; D007472:Iohexol / Q000031:analogs & derivatives; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media; D007472:Iohexol; C038192:iopromide