title: Concomitant Clostridium difficile colitis and cytomegalovirus colitis in an immunocompetent elderly female.
abstract: A 78-year-old Japanese woman with diarrhoea and abdominal pain was admitted for PCR test (PCR)-proven Clostridium difficile colitis. The patient's symptoms persisted despite multiple courses of antibiotics including intravenous metronidazole, oral  vancomycin and oral fidaxomicin. She underwent a stool transplant without improvement. Biopsies from a colonoscopy revealed concomitant cytomegalovirus (CMV) infection. The patient was immediately started on intravenous ganciclovir. Unfortunately, she developed sepsis secondary to colitis, and underwent definitive treatment with a total colectomy. Although CMV is a rare colonic pathogen in the immunocompetent patient, it should be considered in patients with severe or refractory C difficile colitis.
authors.affiliation: Department of Internal Medicine, Madigan Army Medical Center, Tacoma, Washington, USA. maria.kurtz@amedd.army.mil
authors.forename: Maria
authors.initials: M
authors.lastname: Kurtz
authors.forename: Mackenzie
authors.initials: M
authors.lastname: Morgan
mesh_terms: D000368:Aged; D003092:Colitis / Q000150:complications* / Q000821:virology*; D003586:Cytomegalovirus Infections / Q000150:complications*; D004761:Enterocolitis, Pseudomembranous / Q000150:complications*; D005260:Female; D006801:Humans; D007121:Immunocompetence