Lee C-J, Lian J-D, Chang S-W, Chou M-C, Tyan Y-S, Wong L-C, Chang H-R
Department of General Surgery, Chung-Shan Medical University Hospital, Chung-Shan Medical University, Taichung, Taiwan.
Transpl Infect Dis. 2004 Sep;6(3):124-8. doi: 10.1111/j.1399-3062.2004.00063.x.
We report a fatal case of cytomegalovirus (CMV) ischemic colitis in a renal transplant recipient. The disease was manifested with fever of unknown origin for 27 days followed by progressive right lower abdominal pain. The clinical condition deteriorated rapidly with development of disseminated intravascular coagulopathy and internal bleeding despite right hemicolectomy and antiviral therapy. The patient died 11 days after the onset of abdominal pain. We conclude that the possibility of CMV ischemic colitis should be suspected if a patient presents with fever and abdominal pain in the early months after transplantation, and that early viral detection by CMV polymerase chain reaction can be lifesaving.
我们报告了一例肾移植受者发生巨细胞病毒（CMV）缺血性结肠炎的致死病例。该疾病表现为不明原因发热27天，随后出现进行性右下腹痛。尽管进行了右半结肠切除术和抗病毒治疗，但随着弥散性血管内凝血和内出血的发展，临床状况迅速恶化。患者在腹痛发作11天后死亡。我们得出结论，如果患者在移植后的最初几个月出现发热和腹痛，应怀疑有CMV缺血性结肠炎的可能，并且通过CMV聚合酶链反应进行早期病毒检测可能挽救生命。
