Division of Digestive Therapeutic Endoscopy, Department of Gastroenterology, Chang Gung Memorial Hospital, Linkou Medical Center, Tao-Yuan, Taiwan.
J Med Virol. 2010 Apr;82(4):638-41. doi: 10.1002/jmv.21712.
Gastrointestinal infection with cytomegalovirus (CMV) is uncommon in immunocompetent hosts. The case of a 70-year-old male with CMV colitis, who has no history of chronic inflammatory bowel disease or immunodeficiency is described. Diagnosis was aided by the identification of inclusion bodies that reacted positively for CMV by immunohistochemical testing in biopsy specimens from the colonic mucosa. His hospital course was characterized by poor improvement of his symptoms after the CMV infection was treated with ganciclovir, and the occurrence of megacolon. A repeat colonoscopy with biopsy revealed a recurrence of the CMV infection. Although CMV colitis is common in immunocompromised patients, we believe this is the first case of CMV colitis with megacolon and recurrent CMV infection in an immunocompetent patient. Colitis caused by CMV colitis should be considered in elderly people with diarrhea.
巨细胞病毒（CMV）引起的胃肠道感染在免疫功能正常的宿主中并不常见。本文报道了一例 70 岁男性 CMV 结肠炎病例，该患者无慢性炎症性肠病或免疫缺陷病史。通过对结肠黏膜活检标本进行免疫组织化学检测，发现包涵体对 CMV 呈阳性反应，从而辅助诊断了该病例。该患者在使用更昔洛韦治疗 CMV 感染后症状改善不佳，且出现巨结肠，其住院过程的特点为此。重复结肠镜检查和活检显示 CMV 感染复发。虽然 CMV 结肠炎在免疫功能低下的患者中很常见，但我们认为这是首例免疫功能正常的患者发生巨结肠和 CMV 感染复发的 CMV 结肠炎病例。对于出现腹泻的老年人，应考虑 CMV 结肠炎引起的结肠炎。
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