title: [CMV-associated enterocolitis due to primary CMV infection in the immunocompetent].
abstract: Cytomegalovirus (CMV) plays an important role in non-immunocompetent patients due to its high seroprevalence and life-long persistence. However, cases of severe CMV infections are also described in the immunocompetent. Here in particular, the gastrointestinal involvement is of major importance. We describe the case of a 29-year-old immunocompetent young man, who presented with a primary CMV infection mainly of the colon with clinical signs of bloody diarrhoea, fever, hepatitis and haemolysis. The diagnosis was established on the basis of a suspicious endoscopic finding with immunohistochemical detection of CMV in the colonic mucosa, a positive CMV viral load in the peripheral blood and an immune system response typical for primary infection. Based on this case and previous publications, we suggest that a colonoscopy and diagnostic procedures for CMV should be considered if the patient presents with gastrointestinal symptoms like (bloody) diarrhoea, fever, and hepatitis. In a severe case, we recommend antiviral therapy due to a high mortality that has been reported for CMV colitis in immunocompetent individuals.
authors.affiliation: II. Medizinische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München.
authors.forename: C D
authors.initials: CD
authors.lastname: Spinner
authors.forename: R
authors.initials: R
authors.lastname: Vogelmann
authors.forename: D
authors.initials: D
authors.lastname: Hoffmann
authors.forename: J
authors.initials: J
authors.lastname: Nährig
authors.forename: R M
authors.initials: RM
authors.lastname: Schmid
authors.forename: S
authors.initials: S
authors.lastname: von Delius
mesh_terms: D000328:Adult; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000276:immunology* / Q000628:therapy; D003937:Diagnosis, Differential; D004760:Enterocolitis / Q000175:diagnosis* / Q000276:immunology* / Q000628:therapy; D006801:Humans; D007121:Immunocompetence / Q000276:immunology*; D008297:Male; D016896:Treatment Outcome