title: Cytomegalovirus colitis followed by ischemic colitis in a non-immunocompromised adult: a case report.
abstract: We report a rare case of cytomegalovirus (CMV) colitis followed by severe ischemic colitis in a non-immunocompromised patient. An 86-year-old woman was admitted after experiencing episodes of vomiting and diarrhea. The next day, hematochezia was detected without abdominal pain. The initial diagnosis of ischemic colitis was based on colonoscopy and histological findings. The follow-up colonoscopy revealed a prolonged colitis. Immunohistochemical staining detected CMV-positive cells following conservative therapy. Intravenous ganciclovir therapy led to successful healing of ulcers and disappearance of CMV-positive cells. The prevalence of CMV infection is common in adults. CMV colitis is relatively common in immunocompromised patients; however, it is rare in immunocompetent patients. In our case, CMV infection was allowed to be established due to the disruption of the colonic mucosa by the prior severe ischemic colitis. Our experience suggests that biopsies may be necessary to detect CMV and the prompt management of CMV colitis should be instituted when intractable ischemic colitis is observed.
authors.affiliation: Tsuyoshi Hasegawa, Kazuki Aomatsu, Masanori Nakamura, Naoki Aomatsu, Keiho Aomatsu, Department of Surgery, Aomatsu Memorial Hospital, Izumisano, Osaka 598-0001, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Hasegawa
authors.affiliation: Tsuyoshi Hasegawa, Kazuki Aomatsu, Masanori Nakamura, Naoki Aomatsu, Keiho Aomatsu, Department of Surgery, Aomatsu Memorial Hospital, Izumisano, Osaka 598-0001, Japan.
authors.forename: Kazuki
authors.initials: K
authors.lastname: Aomatsu
authors.affiliation: Tsuyoshi Hasegawa, Kazuki Aomatsu, Masanori Nakamura, Naoki Aomatsu, Keiho Aomatsu, Department of Surgery, Aomatsu Memorial Hospital, Izumisano, Osaka 598-0001, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Tsuyoshi Hasegawa, Kazuki Aomatsu, Masanori Nakamura, Naoki Aomatsu, Keiho Aomatsu, Department of Surgery, Aomatsu Memorial Hospital, Izumisano, Osaka 598-0001, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Aomatsu
authors.affiliation: Tsuyoshi Hasegawa, Kazuki Aomatsu, Masanori Nakamura, Naoki Aomatsu, Keiho Aomatsu, Department of Surgery, Aomatsu Memorial Hospital, Izumisano, Osaka 598-0001, Japan.
authors.forename: Keiho
authors.initials: K
authors.lastname: Aomatsu
mesh_terms: D061605:Administration, Intravenous; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000008:administration & dosage; D001706:Biopsy; D003092:Colitis / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D017091:Colitis, Ischemic / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology*; D003113:Colonoscopy; D003586:Cytomegalovirus Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D015774:Ganciclovir / Q000008:administration & dosage; D006801:Humans; D007121:Immunocompetence; D007150:Immunohistochemistry; D012074:Remission Induction; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D015774:Ganciclovir
keywords: Colitis; Cytomegalovirus infection; Infectious disease; Ischemic colitis; Non-immunosuppression
references.citation: Virol J. 2008;5:47
references.pmid: 18371229
references.citation: Dig Dis Sci. 2005 Apr;50(4):609-16
references.pmid: 15844689
references.citation: Arch Pathol Lab Med. 2005 Feb;129(2):200-4
references.pmid: 15679421
references.citation: Transpl Infect Dis. 2004 Sep;6(3):124-8
references.pmid: 15569229
references.citation: Clin Infect Dis. 1997 Jan;24(1):52-6
references.pmid: 8994755
references.citation: Clin Transplant. 2004 Feb;18(1):100-4
references.pmid: 15108778
references.citation: J Clin Virol. 2002 Aug;25 Suppl 2:S1-12
references.pmid: 12361752
references.citation: Am J Gastroenterol. 2001 Jul;96(7):2137-42
references.pmid: 11467645
references.citation: Virol J. 2013;10:43
references.pmid: 23374225
references.citation: Saudi J Kidney Dis Transpl. 2013 Mar;24(2):309-14
references.pmid: 23538355