Cytomegalovirus proctitis mimicking rectal cancer in an immunocompetent elderly patient: a case report.
BACKGROUND
Cytomegalovirus infection is associated with significant morbidity and mortality in immunocompromised patients, but its impact on immunocompetent patients is still poorly understood. Furthermore, there is increasing evidence implying that chronic infection may contribute to a heightened cardiovascular risk.


METHODS
We describe the case of incidental diagnosis of Cytomegalovirus proctitis in an immune-competent white British elderly gentleman, admitted following a stroke and investigated for rectal cancer following the development of bloody diarrhoea and persistent systemic inflammatory response.


CONCLUSIONS
This raised some several interesting points; firstly that we must revise our approach to investigating the immunocompetent elderly patient, secondly, could chronic Cytomegalovirus infection have contributed to the presentation of stroke in this patient and lastly what are the existing evidence for treatment in this population? We use this opportunity to try and address some of these questions and feel that this would be of benefit to the wider audience.We discuss the risk factors for disease in immune-competent patients and also a brief overview of the benefits of treatment in this population.
Department of Pathology, North Middlesex University Hospital, Sterling Way, N181QX London, UK. sathyavani81@gmail.com.
Sathyavani
S
Subbarao
Anthony
A
O'Sullivan
Tolu
T
Adesina
Adam M
AM
Gwozdz
Julia
J
Rees
Giovanni
G
Satta
D000368:Aged; D003587:Cytomegalovirus / Q000502:physiology*; D003586:Cytomegalovirus Infections / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D003937:Diagnosis, Differential; D006801:Humans; D007121:Immunocompetence; D008297:Male; D011349:Proctitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D011860:Radiography, Abdominal; D012004:Rectal Neoplasms / Q000175:diagnosis* / Q000473:pathology; D014057:Tomography, X-Ray Computed