title: Small bowel perforation due to CMV enteritis infection in an HIV-positive patient.
abstract: BACKGROUND
  Cytomegalovirus infection of the gastrointestinal tract is common and is more often seen in patients with acquired immunodeficiency syndrome (AIDS). Although small bowel infection is less common than infection of other parts of the gastrointestinal system, it may lead to perforation, an acute complication, with dreadful results.
  
  
  METHODS
  This article reports a case of Cytomegalovirus ileitis with multiple small bowel perforations in a young man with human immunodeficiency virus (HIV) infection. The patient developed abdominal pain with diarrhea and fever, and eventually acute abdomen with pneumoperitoneum. The patient had poor prognosis and deceased despite the prompt surgical intervention and the antiviral therapy he received. At pathology a remarkable finding was the presence of viral inclusions in smooth muscle fibers. The destruction of muscle cells was the main cause of perforation.
  
  
  CONCLUSIONS
  Morbidity and mortality associated with perforation from CMV enteritis in AIDS patients are high and the life expectancy is short. Cytomegalovirus disease is multifocal; therefore, excision of one portion of the gastrointestinal tract may be followed by a complication elsewhere. Our case elucidate that muscle cell destruction by the virus is a significant cause leading to perforation.
authors: Department of Surgery, Aristotle University of Thessaloniki, Thessaloniki, Greece. nickos.michalopoulos@gmail.com
authors: Nick
authors: N
authors: Michalopoulos
authors: Konstantina
authors: K
authors: Triantafillopoulou
authors: Eleni
authors: E
authors: Beretouli
authors: Styliani
authors: S
authors: Laskou
authors: Theodossis S
authors: TS
authors: Papavramidis
authors: Ioannis
authors: I
authors: Pliakos
authors: Prodromos
authors: P
authors: Hytiroglou
authors: Spiros T
authors: ST
authors: Papavramidis
mesh_terms: D000328:Adult; D003586:Cytomegalovirus Infections / Q000150:complications*; D004751:Enteritis / Q000150:complications*; D015658:HIV Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D007416:Intestinal Perforation / Q000175:diagnosis* / Q000821:virology; D007421:Intestine, Small / Q000473:pathology*; D008279:Magnetic Resonance Imaging; D008297:Male
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