Kjaer Anna Sophie L, Ribberholt Iben, Thomsen Kim, Ibsen Per H, Markova Elena, Graff Jesper
Department of Infectious diseases, Copenhagen University Hospital Hvidovre, Kettegaards Allé 30, DK-2650 Hvidovre, Denmark.
Department of Clinical microbiology, Copenhagen University Hospital Rigshospitalet, Blegdamsvej 9, DK-2100 Copenhagen Ø, Denmark.
Diagnostics (Basel). 2018 Dec 26;9(1):3. doi: 10.3390/diagnostics9010003.
We present a case demonstrating the diagnostic work-up of a patient undergoing azathioprine treatment for inflammatory bowel disease (IBD), diagnosed with an acute cytomegalovirus (CMV) infection and CMV colitis. An F-FDG positron emission tomography/computed tomography (PET/CT) performed 2 weeks after debut of symptoms revealed pathological F-FDG uptake in the left side of the colon mucosa, mimicked activity of IBD. However, a diagnosis of CMV colitis was based on the presence of CMV IgM antibodies, a seroconversion of CMV IgG antibodies, presence of CMV DNA in plasma and the finding af CMV DNA in biopsies from the intestinal mucosa. The patient responded to treatment with ganciclovir. This case highlights that a positive F-FDG PET/CT scan of the colon can be due to CMV colitis.
我们报告一例病例，该患者因炎症性肠病（IBD）接受硫唑嘌呤治疗，被诊断为急性巨细胞病毒（CMV）感染和CMV结肠炎。症状出现2周后进行的F-FDG正电子发射断层扫描/计算机断层扫描（PET/CT）显示结肠黏膜左侧有病理性F-FDG摄取，类似IBD的活动。然而，CMV结肠炎的诊断基于CMV IgM抗体的存在、CMV IgG抗体的血清转化、血浆中CMV DNA的存在以及肠道黏膜活检中CMV DNA的发现。患者对更昔洛韦治疗有反应。该病例强调结肠F-FDG PET/CT扫描阳性可能是由于CMV结肠炎。
