title: Disseminated CMV and Tuberculosis Infection with Osseous Metaplasia in a Presumable Crohn's Patient: Case Report.
abstract: Associations of different pathologies are not uncommon in every day practice, but association of disseminated infections like cytomegalovirus infection and tuberculosis are quite rare and hard to diagnose. Both are infections which appear frequently in immunocompromised patients and have unfavorable prognosis. We present a case of a 62 year old male with a history of Crohn's disease and tuberculosis which presented with symptoms of relapse and infection. He was treated with immunosuppressive medication and cortisol for the past 6 weeks. Cytomegalovirus (CMV) infection was serologically confirmed. In evolution, he suffered from gastrointestinal hemorrhage and died afterwards due to the hemorrhage and pulmonary infections. Histology confirmed the CMV modification in the lungs and intestines, but also highlighted active and disseminated tuberculosis (TB), bronchopneumonia, osseous metaplasia, hyaline membranes, numerous TB abscesses in the intestinal wall and specific CMV and TB modifications in the liver. The trigger for such important and serious infections remains unclear, for the cause can be represented by the Crohn's disease per se or only by the immunosuppressive treatment. Also, CMV can trigger modifications in immune system and patients with immune-mediated diseases have an increased risk for TB reactivation.
authors.affiliation: Department of Pathology, Emergency University Hospital, Bucharest, Romania.
authors.forename: Oana Maria
authors.initials: OM
authors.lastname: Patrascu
authors.affiliation: Department of Obstetrics and Gynecology, Emergency University Hospital,"Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Monica
authors.initials: M
authors.lastname: Cirstoiu
authors.affiliation: Department of Pathology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Anca Mihaela
authors.initials: AM
authors.lastname: Lazaroiu
authors.affiliation: Department of Pathology, Emergency University Hospital, Bucharest, Romania.
authors.forename: Adrian Vasile
authors.initials: AV
authors.lastname: Dumitru
authors.affiliation: Department of Pathology, Emergency University Hospital, Bucharest, Romania.
authors.forename: Andreea Elena
authors.initials: AE
authors.lastname: Mihai
authors.affiliation: Department of Pathology, Emergency University Hospital, Bucharest, Romania.
authors.forename: Manuela
authors.initials: M
authors.lastname: Popa
authors.affiliation: Department of Gastroenterology and Hepatology, Fundeni Clinical Institute, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Anca
authors.initials: A
authors.lastname: Dimitriu
authors.affiliation: Department of Pathology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Maria
authors.initials: M
authors.lastname: Sajin
authors.affiliation: Department of Pathology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Mariana
authors.initials: M
authors.lastname: Costache
authors.affiliation: Department of Pathology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: Andreea
authors.initials: A
authors.lastname: Iliesiu