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一例免疫功能正常的新冠病毒肺炎患者发生巨细胞病毒性结肠炎的病例。

A Case of Cytomegalovirus Colitis in an Immunocompetent COVID-19 Patient.

作者信息

Bakir Mohamad, Rebh Fatima, Mahdi Elham, AlFiaar Abdullah, Mansoor Gaafar S

机构信息

College of Medicine, Alfaisal University, Riyadh, SAU.

Department of Internal Medicine, Section of Infectious Diseases, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, SAU.

出版信息

Cureus. 2022 Mar 16;14(3):e23203. doi: 10.7759/cureus.23203. eCollection 2022 Mar.

DOI:10.7759/cureus.23203
PMID:35444867
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9010931/
Abstract

Cytomegalovirus (CMV) is a double-stranded DNA virus that belongs to the herpesvirus family. In the immunocompetent host, CMV infection is usually mild and goes unnoticed. Patients become prone to CMV infection as a result of immunosuppressive drugs or disorders that weaken cellular immunity. In severe COVID-19 infection, the patient experiences a drop in his T lymphocytes and becomes prone to opportunistic infections such as CMV colitis. In this paper, we presented a rare case of CMV colitis in a 54-year-old female with a positive severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) polymerase chain reaction. The patient was admitted to the intensive care unit and intubated due to the severity of her presentation. The patient received high-dose dexamethasone followed by a tapering dose of prednisolone. Fifteen days post-admission, the patient started to have melena with a drop in her hemoglobin. Sigmoidoscopy revealed ulcerated lesions that extended 5 cm proximally, and multiple biopsies confirmed the diagnosis of CMV colitis. The patient was started on ganciclovir 5 mg/kg intravenously for 21 days. The patient's symptoms improved to the point where she no longer complained of melena, and her hemoglobin level normalized. The patient was discharged home in stable condition, to be followed later in the outpatient clinic.

摘要

巨细胞病毒(CMV)是一种双链DNA病毒,属于疱疹病毒科。在免疫功能正常的宿主中,CMV感染通常较轻,不易被察觉。由于免疫抑制药物或削弱细胞免疫的疾病,患者容易发生CMV感染。在严重的COVID-19感染中,患者的T淋巴细胞会减少,容易发生机会性感染,如CMV结肠炎。在本文中,我们报告了一例罕见的CMV结肠炎病例,患者为一名54岁女性,严重急性呼吸综合征冠状病毒2(SARS-CoV2)聚合酶链反应呈阳性。由于病情严重,患者被收入重症监护病房并插管。患者接受了大剂量地塞米松治疗,随后逐渐减量使用泼尼松龙。入院15天后,患者开始出现黑便,血红蛋白下降。乙状结肠镜检查发现溃疡病变向近端延伸5厘米,多次活检确诊为CMV结肠炎。患者开始静脉注射更昔洛韦,剂量为5毫克/千克,持续21天。患者的症状有所改善,不再抱怨黑便,血红蛋白水平恢复正常。患者出院时病情稳定,随后将在门诊进行随访。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d5/9010931/2483ebd97bfb/cureus-0014-00000023203-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d5/9010931/0ad132cefb22/cureus-0014-00000023203-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d5/9010931/16b26678a283/cureus-0014-00000023203-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d5/9010931/7d3d1c2805f5/cureus-0014-00000023203-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d5/9010931/da8a06eb7bdf/cureus-0014-00000023203-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d5/9010931/2483ebd97bfb/cureus-0014-00000023203-i05.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d5/9010931/0ad132cefb22/cureus-0014-00000023203-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d5/9010931/16b26678a283/cureus-0014-00000023203-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d5/9010931/7d3d1c2805f5/cureus-0014-00000023203-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d5/9010931/da8a06eb7bdf/cureus-0014-00000023203-i04.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/49d5/9010931/2483ebd97bfb/cureus-0014-00000023203-i05.jpg

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