[CMV-associated enterocolitis due to primary CMV infection in the immunocompetent]

Z Gastroenterol. 2013 Nov;51(11):1259-63. doi: 10.1055/s-0031-1273487. Epub 2013 Jan 9.
[Article in German]

Abstract

Cytomegalovirus (CMV) plays an important role in non-immunocompetent patients due to its high seroprevalence and life-long persistence. However, cases of severe CMV infections are also described in the immunocompetent. Here in particular, the gastrointestinal involvement is of major importance. We describe the case of a 29-year-old immunocompetent young man, who presented with a primary CMV infection mainly of the colon with clinical signs of bloody diarrhoea, fever, hepatitis and haemolysis. The diagnosis was established on the basis of a suspicious endoscopic finding with immunohistochemical detection of CMV in the colonic mucosa, a positive CMV viral load in the peripheral blood and an immune system response typical for primary infection. Based on this case and previous publications, we suggest that a colonoscopy and diagnostic procedures for CMV should be considered if the patient presents with gastrointestinal symptoms like (bloody) diarrhoea, fever, and hepatitis. In a severe case, we recommend antiviral therapy due to a high mortality that has been reported for CMV colitis in immunocompetent individuals.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Adult
  • Cytomegalovirus / immunology
  • Cytomegalovirus Infections / diagnosis*
  • Cytomegalovirus Infections / immunology*
  • Cytomegalovirus Infections / therapy
  • Diagnosis, Differential
  • Enterocolitis / diagnosis*
  • Enterocolitis / immunology*
  • Enterocolitis / therapy
  • Humans
  • Immunocompetence / immunology*
  • Male
  • Treatment Outcome