title: Clinical presentation and risk factors for cytomegalovirus colitis in immunocompetent adult patients.
abstract: BACKGROUND
  Cytomegalovirus (CMV) colitis is a common manifestation of CMV end-organ disease, which has typically been described in immunocompromised hosts. Recently, it has been noted that this also occurs in immunocompetent patients. To gather relevant data about clinical presentation, prognosis, and risk factors for development of CMV colitis in immunocompetent hosts, we analyzed all cases that occurred during a 19-year period at our institution.
  
  
  METHODS
  A case-control study was performed to identify risk factors for CMV colitis in immunocompetent hosts. Electronic medical records of individuals who were admitted and diagnosed with CMV colitis between January 1995 and February 2014 at a tertiary care university hospital were reviewed. Two non-CMV colitis patients who were age- and sex-matched were selected as controls for each case.
  
  
  RESULTS
  A total of 51 patients with CMV colitis were included in this study along with 102 control patients. Certain conditions including renal disease on hemodialysis, neurologic disease, rheumatologic disease, intensive care unit admission, and exposure to antibiotics, antacids, steroids, or red blood cell (RBC) transfusions within 1 month of diagnosis of colitis were associated with CMV colitis on univariate analysis. Among these, steroid use and RBC transfusion within 1 month were identified as independent risk factors for developing CMV colitis on multivariate analysis. The 30-day mortality rate was 7.8% without any attributable mortality.
  
  
  CONCLUSIONS
  Steroid use and RBC transfusion within 1 month of the diagnosis of colitis were independent risk factors for development of CMV colitis in immunocompetent hosts.
authors.affiliation: Division of Infectious Diseases.
authors.forename: Jae-Hoon
authors.initials: JH
authors.lastname: Ko
authors.affiliation: Division of Infectious Diseases.
authors.forename: Kyong Ran
authors.initials: KR
authors.lastname: Peck
authors.affiliation: Division of Infectious Diseases.
authors.forename: Woo Joo
authors.initials: WJ
authors.lastname: Lee
authors.affiliation: Division of Infectious Diseases.
authors.forename: Ji Yong
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Division of Infectious Diseases.
authors.forename: Sun Young
authors.initials: SY
authors.lastname: Cho
authors.affiliation: Division of Infectious Diseases.
authors.forename: Young Eun
authors.initials: YE
authors.lastname: Ha
authors.affiliation: Division of Infectious Diseases.
authors.forename: Cheol-In
authors.initials: CI
authors.lastname: Kang
authors.affiliation: Division of Infectious Diseases.
authors.forename: Doo Ryeon
authors.initials: DR
authors.lastname: Chung
authors.affiliation: Division of Gastroenterology.
authors.forename: Young-Ho
authors.initials: YH
authors.lastname: Kim
authors.affiliation: Department of Laboratory Medicine.
authors.forename: Nam Yong
authors.initials: NY
authors.lastname: Lee
authors.affiliation: Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: Kyoung-Mee
authors.initials: KM
authors.lastname: Kim
authors.affiliation: Division of Infectious Diseases.
authors.forename: Jae-Hoon
authors.initials: JH
authors.lastname: Song
mesh_terms: D000293:Adolescent; D000368:Aged; D001803:Blood Transfusion; D016022:Case-Control Studies; D015984:Causality; D003092:Colitis / Q000175:diagnosis* / Q000821:virology*; D003587:Cytomegalovirus / Q000472:pathogenicity; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000209:etiology* / Q000401:mortality; D057286:Electronic Health Records; D005260:Female; D006801:Humans; D007121:Immunocompetence; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D062606:Tertiary Care Centers / Q000706:statistics & numerical data; D013997:Time Factors
keywords: blood transfusion; colitis; cytomegalovirus; risk factors; steroids