Choi S W, Chung J P, Song Y K, Park Y N, Chu J K, Kim D J, Jung J H, Lee C H, Lee S J, Park H J, Lee K S, Lee S I, Park I S, Sohn S K
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
Yonsei Med J. 2001 Feb;42(1):147-51. doi: 10.3349/ymj.2001.42.1.147.
Cytomegalovirus (CMV) infections are commonly reported in severely immunocompromised hosts and ulcers of the alimentary tract are frequently observed in systemic CMV infections. However, invasive and ulcerative disease of the gastrointestinal (GI) tract caused by CMV has also been reported in healthy adults. Many reports show that a CMV infection can produce localized ulcerations in the esophagus, stomach, small intestine, and colon in nonimmunocompromised individuals. The most common site of involvement by CMV infection in the GI tract is the colon followed by the upper GI tract and the least common site is the small intestine. Although GI bleeding is one of the major presenting symptoms of patients with CMV infections of the GI tract, lower GI bleeding due to CMV ileal ulcers in immunocompetent patients, to our knowledge, has not been reported in the English literature. Recently, we experienced a case of lower GI bleeding due to CMV ileal ulcers in a 57-year-old man who had no evidence of immunocompromise. This case suggests that small intestinal ulcers due to CMV infection should be included in the differential diagnosis of lower GI bleeding even in immunocompetent hosts.
巨细胞病毒（CMV）感染在严重免疫功能低下的宿主中很常见，在全身性CMV感染中经常观察到消化道溃疡。然而，CMV引起的胃肠道（GI）侵袭性和溃疡性疾病在健康成年人中也有报道。许多报告表明，CMV感染可在非免疫功能低下个体的食管、胃、小肠和结肠产生局部溃疡。CMV感染在胃肠道中最常累及的部位是结肠，其次是上消化道，最不常见的部位是小肠。虽然胃肠道出血是胃肠道CMV感染患者的主要表现症状之一，但据我们所知，免疫功能正常的患者因CMV回肠溃疡导致的下消化道出血在英文文献中尚未见报道。最近，我们遇到一例57岁男性因CMV回肠溃疡导致下消化道出血，该患者无免疫功能低下的证据。该病例表明，即使在免疫功能正常的宿主中，CMV感染引起的小肠溃疡也应列入下消化道出血的鉴别诊断中。
