title: Cytomegalovirus colitis in immunocompetent patients: a clinical and endoscopic study.
abstract: OBJECTIVE
  Cytomegalovirus (CMV) colitis occurs rarely in immunocompetent patients and little detail is known about the clinical features, endoscopic findings and prognosis of CMV colitis in immunocompetent patients. The aim of this study was to investigate the clinical and endoscopic features of CMV colitis and its prognosis in immunocompetent patients.
  
  
  METHODS
  We retrospectively reviewed the medical records and the endoscopic findings of twelve immunocompetent patients who were diagnosed with CMV colitis by immunostaining for CMV antibodies based on the histological examination of tissue biopsies obtained during colonoscopy. The patients were six men and six women and their median age was 66 years (range 44-88).
  
  
  RESULTS
  Patients infected with CMV colitis had comorbidities including diabetes mellitus (n=4), chronic renal failure (n=3) and ischemic heart disease (n=2). The most common initial presenting symptom was gastrointestinal bleeding (n=7) and the associated symptoms were diarrhea and abdominal pain. Endoscopic examination showed three types: well-demarcated ulcerative type (n=6), ulceroinfiltrative type (n=3), and pseudomembranous colitis-associated type (n=3). All patients were treated with an antiviral agent (ganciclovir) within two weeks following onset of main presenting symptom and all showed clinical and endoscopic improvement except one died later from severe pneumonia.
  
  
  CONCLUSIONS
  CMV colitis in immunocompetent patients presented in older patients and in those with other comorbidities. Gastrointestinal bleeding was the most common initial presentation. Despite aggressive clinical manifestations, the prognosis of CMV colitis is good if diagnosed and treated early.
authors: Department of Internal Medicine, Digestive Disease Center, Konkuk University School of Medicine, Konkuk University Medical Center, Seoul, Korea.
authors: Tae Ho
authors: TH
authors: Seo
authors: Jeong Hwan
authors: JH
authors: Kim
authors: Soon Young
authors: SY
authors: Ko
authors: Sung Noh
authors: SN
authors: Hong
authors: Sun-Young
authors: SY
authors: Lee
authors: In-Kyung
authors: IK
authors: Sung
authors: Hyung Seok
authors: HS
authors: Park
authors: Chan Sub
authors: CS
authors: Shim
authors: Hye Seung
authors: HS
authors: Han
mesh_terms: D015746:Abdominal Pain / Q000453:epidemiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000914:Antibodies, Viral / Q000032:analysis; D000998:Antiviral Agents / Q000627:therapeutic use; D001706:Biopsy; D003093:Colitis, Ulcerative / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000473:pathology* / Q000821:virology; D003106:Colon / Q000276:immunology / Q000473:pathology* / Q000821:virology; D003113:Colonoscopy; D015897:Comorbidity; D003587:Cytomegalovirus / Q000276:immunology; D003586:Cytomegalovirus Infections / Q000188:drug therapy / Q000453:epidemiology / Q000276:immunology / Q000473:pathology* / Q000821:virology; D003967:Diarrhea / Q000453:epidemiology; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology; D006801:Humans; D007121:Immunocompetence; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000914:Antibodies, Viral; D000998:Antiviral Agents; D015774:Ganciclovir