Siegal Daniel S, Hamid Naveed, Cunha Burke A
Infectious Disease Division, Winthrop-University Hospital, Mineola, NY 11501, USA.
Heart Lung. 2005 Jul-Aug;34(4):291-4. doi: 10.1016/j.hrtlng.2004.08.009.
Cytomegalovirus (CMV) causes infections in healthy individuals and compromised hosts. In compromised hosts, CMV may cause encephalitis, pneumonia, hepatitis, colitis, and so forth. In immunocompetent hosts, CMV mononucleosis is the most common clinical manifestation and CMV colitis is rare. We present a case of an 82-year-old immunocompetent man who presented with community-acquired bloody diarrhea. A computed tomography scan of the abdomen revealed pan-colitis. His age and abdominal pains suggested ischemic colitis as the cause of his bloody diarrhea. Workup for Clostridium difficile and all enteric pathogens were negative. The patient remained febrile with abdominal pain. During the second week, he underwent sigmoidoscopy for biopsy, which revealed viral inclusions of the Cowdry owl eye inclusion bodies characteristic of CMV. CMV colitis was diagnosed in the patient; he was successfully treated with a course of oral valganciclovir and made an uneventful recovery.
巨细胞病毒（CMV）可导致健康个体和免疫功能低下宿主感染。在免疫功能低下宿主中，CMV可引起脑炎、肺炎、肝炎、结肠炎等。在免疫功能正常宿主中，CMV单核细胞增多症是最常见的临床表现，而CMV结肠炎则较为罕见。我们报告一例82岁免疫功能正常男性，表现为社区获得性血性腹泻。腹部计算机断层扫描显示全结肠炎。他的年龄和腹痛提示缺血性结肠炎是其血性腹泻的病因。艰难梭菌及所有肠道病原体的检查均为阴性。患者持续发热并伴有腹痛。在第二周，他接受了乙状结肠镜检查以进行活检，结果显示具有CMV特征性的考德里A型包涵体的病毒包涵体。该患者被诊断为CMV结肠炎；他接受了一个疗程的口服缬更昔洛韦治疗，治疗成功，恢复顺利。
