title: [A case of cytomegalovirus colitis during chemotherapy for esophageal cancer].
abstract: We report a case of a patient who developed cytomegalovirus colitis during chemotherapy for esophageal cancer. A 62- year-old man was admitted to our hospital complaining of epigastralgia and dysphagia. He was diagnosed as having esophageal cancer( Mt, type 3, cT3, cN2, cM0, cStage III). Neoadjuvant chemotherapy with 5-fluorouracil( 5-FU) and cisplatin (CDDP) was initiated. However, after 1 course of chemotherapy, the patient experienced a stroke. Subsequently, he was treated with radical chemoradiotherapy. Chemoradiotherapy with low-dose docetaxel was administered. However, he developed interstitial pneumonia, and thus received pulse corticosteroid therapy with methylprednisolone. On the 26th day after steroid therapy, he developed melena. Colonoscopy revealed multiple punched-out ulcers in the transverse colon, and the patient was diagnosed as having cytomegalovirus colitis on the basis of positive cytomegalovirus antigenemia. Intravenous ganciclovir therapy was initiated. On the 13th day after ganciclovir therapy, the patient required an emergency surgery because of perforation-related peritonitis. We identified a perforation in the ascending colon and performed ileocecal resection. Although he was treated with paclitaxel, he died of esophagotracheal fistula and aspiration pneumonitis. We should be aware of cytomegalovirus colitis during chemotherapy and corticosteroid therapy.
authors.affiliation: Dept. of Digestive Surgery and Surgical Oncology, Yamaguchi University Graduate School of Medicine.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kitahara
authors.forename: Shinsuke
authors.initials: S
authors.lastname: Kanekiyo
authors.forename: Tsunenori
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Yusaku
authors.initials: Y
authors.lastname: Watanabe
authors.forename: Shigeru
authors.initials: S
authors.lastname: Takeda
authors.forename: Tomio
authors.initials: T
authors.lastname: Ueno
authors.forename: Shigefumi
authors.initials: S
authors.lastname: Yoshino
authors.forename: Shoichi
authors.initials: S
authors.lastname: Hazama
authors.forename: Masaaki
authors.initials: M
authors.lastname: Oka
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D000998:Antiviral Agents / Q000627:therapeutic use; D002945:Cisplatin / Q000008:administration & dosage; D003092:Colitis / Q000188:drug therapy / Q000821:virology*; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000188:drug therapy; D004938:Esophageal Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D017809:Fatal Outcome; D005472:Fluorouracil / Q000008:administration & dosage; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged
chemical_list: D000998:Antiviral Agents; D015774:Ganciclovir; D002945:Cisplatin; D005472:Fluorouracil