title: Acute appendicitis due to Cytomegalovirus in an apparently immunocompetent patient: a case report.
abstract: BACKGROUND
  In healthy subjects, Cytomegalovirus infection can be asymptomatic or manifest as mononucleosis syndrome, but organ disease has also been reported. However, in immunocompromised patients this infection can lead to its most significant and severe disease and even mortality. When Cytomegalovirus causes a gastrointestinal tract infection, it more commonly manifests with luminal tract disease and is usually characterized by ulcerative lesions. Appendicitis is a rare manifestation, and has been reported mainly in human immunodeficiency virus-infected patients or patients with other causes of immunocompromise.
  
  
  METHODS
  The authors report on a case of acute primary Cytomegalovirus infection complicated with acute appendicitis due to Cytomegalovirus in an apparently immunocompetent 24-year-old Caucasian man also suffering from primary sclerosing cholangitis and ulcerative colitis. Diagnosis was based on clinical manifestations, serology results, as well as microbiological and histological findings. Treatment consisted of surgery and anti-Cytomegalovirus therapy.
  
  
  CONCLUSIONS
  Cytomegalovirus should be included among the etiologic agents of acute appendicitis in patients with primary sclerosing cholangitis and ulcerative colitis. Currently, there are no definitive data regarding the frequency of Cytomegalovirus appendicitis and the role of anti-Cytomegalovirus treatment in human immunodeficiency virus-negative and apparently immunocompetent subjects.
authors.affiliation: Infectious Disease, Department Experimental Medicine and Biochemical Sciences, University of Perugia, 06100 Perugia, Italy. mariabruna.pasticci@unipg.it.
authors.forename: Maria Bruna
authors.initials: MB
authors.lastname: Pasticci
authors.forename: Simona
authors.initials: S
authors.lastname: Corsi
authors.forename: Francesca
authors.initials: F
authors.lastname: Spigarelli
authors.forename: Stefano
authors.initials: S
authors.lastname: Correnti
authors.forename: Daniela
authors.initials: D
authors.lastname: Francisci
authors.forename: Roberto
authors.initials: R
authors.lastname: Castronari
authors.forename: Pamela
authors.initials: P
authors.lastname: Baldin
authors.forename: Annapaola
authors.initials: A
authors.lastname: Prosperini
authors.forename: Franco
authors.initials: F
authors.lastname: Baldelli
authors.forename: Elio
authors.initials: E
authors.lastname: Cenci
authors.forename: Alessandra
authors.initials: A
authors.lastname: Sensini
authors.forename: Olivia
authors.initials: O
authors.lastname: Morelli