title: Cytomegalovirus Colitis in a Critically Ill Patient Following Severe Legionella Pneumonia with Multiple Organ Failure.
abstract: A 68-year-old man visited an emergency department complaining of dyspnea. He was diagnosed to have Legionella pneumonia with multiple organ failure. Although his multiple organ failure improved, he suffered from persistent abdominal pain and diarrhea with continuous minor bleeding. Colonoscopy revealed a longitudinal ulcer of the rectum, below the peritoneal reflection. He was diagnosed with cytomegalovirus (CMV) colitis. Antiviral therapy with ganciclovir was initiated. He finally underwent a colostomy after a bowel stricture caused an intestinal outlet obstruction, which made oral intake impossible. Based on the present case, we believe that CMV colitis must be considered as one of the differential diagnoses when critically ill patients develop continuous diarrhea and abdominal pain.
authors.affiliation: Department of Pulmonary Medicine, Kameda Medical Center, Japan.
authors.forename: Kei
authors.initials: K
authors.lastname: Nakashima
authors.forename: Masahiro
authors.initials: M
authors.lastname: Aoshima
authors.forename: Fumi
authors.initials: F
authors.lastname: Suzuki
authors.forename: Junko
authors.initials: J
authors.lastname: Watanabe
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Otsuka
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D003092:Colitis / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D003113:Colonoscopy; D003125:Colostomy; D016638:Critical Illness; D003587:Cytomegalovirus / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000503:physiopathology; D003937:Diagnosis, Differential; D003967:Diarrhea / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D007875:Legionella / Q000302:isolation & purification*; D007877:Legionnaires' Disease / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D009102:Multiple Organ Failure / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology*; D011014:Pneumonia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000998:Antiviral Agents; D015774:Ganciclovir