Case of cytomegalovirus colitis in an immunocompetent patient: a rare cause of abdominal pain and diarrhea in the elderly

International Journal of General Medicine
Yumi HaranoHiroko Arioka

Abstract

Cytomegalovirus (CMV) colitis usually occurs in immunocompromised patients after undergoing organ transplantation or chemotherapy. We report the case of a 60-year-old immunocompetent Japanese woman who presented with abdominal pain and bloody diarrhea. She was initially diagnosed as having ischemic colitis with pseudomembranous colitis on the basis of her symptoms, Clostridium difficile antigen positivity, and colonoscopic findings, which showed ulcer formation from the sigmoid colon to rectum. In spite of bowel rest and administration of metronidazole, her symptoms did not improve. On follow-up colonoscopy, ulcerations remained unchanged. Biopsy of the ulceration revealed CMV-infected cells leading to a diagnosis of CMV colitis. CMV colitis is a rare but possible differential diagnosis in immunocompetent patients. We recommend endoscopic biopsy in a case of refractory abdominal pain and bloody diarrhea.

Citations

Feb 7, 2016·Journal of Microbiology, Immunology, and Infection = Wei Mian Yu Gan Ran Za Zhi·Khee-Siang ChanWen-Liang Yu
Jul 30, 2016·Archives of Pathology & Laboratory Medicine·Nick Baniak, Rani Kanthan
Aug 17, 2016·Journal of Infection and Chemotherapy : Official Journal of the Japan Society of Chemotherapy·Hideyuki HayashiAkira Fujinaga
Sep 28, 2017·Nature Reviews. Gastroenterology & Hepatology·Steven NaymagonJames Ferrara
Nov 28, 2019·Breast Cancer : the Journal of the Japanese Breast Cancer Society·Jie-Ru Yang, Yen-Chen Shao
Feb 29, 2020·World Journal of Clinical Cases·Joon Hyun Cho, Joon Hyuk Choi

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Methods Mentioned

BETA
lavage
biopsy

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