Surapaneni Balarama K, Priyadarshni Shivani, Choksi Vivek, Sorathia Sufian, Kasmin Franklin
Internal Medicine, Aventura Hospital and Medical Center, Aventura, USA.
Gastroenterology, Aventura Hospital and Medical Center, Aventura, USA.
Cureus. 2020 Jul 27;12(7):e9432. doi: 10.7759/cureus.9432.
Cytomegalovirus (CMV) infections are typically seen in individuals with immunosuppressive conditions such as malignancies, HIV/AIDS, and organ transplantation, and in patients on chemotherapy or steroids. Recurrent disease can occur if the virus reactivates due to disruption of immunity due to factors such as older age or immunosuppressive drugs. CMV is common, with a seroprevalence (CMV IgG-positive) of 40-100 % in adults, increasing with age. It has been reported that inflammatory bowel disease in remission can be exacerbated by CMV colitis or complicate steroids refractory colitis flare. For this reason, steroids should be cautiously started if clinical suspicion is high for CMV. We report a unique case of CMV colitis associated with severe ischemic colitis in an immunocompetent patient, with an excellent response to management with antiviral therapy.
巨细胞病毒(CMV)感染通常见于患有免疫抑制性疾病的个体,如恶性肿瘤、HIV/AIDS和器官移植患者,以及接受化疗或使用类固醇的患者。如果由于年龄较大或免疫抑制药物等因素导致免疫力破坏,病毒重新激活,就可能发生复发性疾病。CMV很常见,成年人中血清阳性率(CMV IgG阳性)为40%-100%,且随年龄增长而增加。据报道,缓解期的炎症性肠病可因CMV结肠炎而加重,或使类固醇难治性结肠炎发作复杂化。因此,如果临床高度怀疑CMV,应谨慎开始使用类固醇。我们报告了一例免疫功能正常的患者发生CMV结肠炎并伴有严重缺血性结肠炎的独特病例,抗病毒治疗对其治疗效果极佳。