Division of Gastroenterology, Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Korean J Gastroenterol. 2023 Mar 25;81(3):133-136. doi: 10.4166/kjg.2022.134.
A infection (CDI) is one of the major nosocomial diarrheal diseases. Pseudomembranous colitis (PMC) is a characteristic endoscopic finding of CDI, manifested by white or yellowish plaque covering the colonic mucosa. Ischemic colitis is inflammation of the colon manifested by mucosal denudation and friability. Ischemic colitis is rarely associated with CDI. The treatment response might be delayed when CDI is complicated with other diseases that cause diarrhea. Thus far, reports of CDI concomitant with Cytomegalovirus (CMV) colitis are rare. This paper reports a case of PMC and ischemic colitis associated with CDI and CMV infection. After two weeks of oral vancomycin and intravenous metronidazole, the patient's diarrhea was not improved. Follow-up sigmoidoscopy was performed, and a CMV infection was identified at areas of broad ulceration where ischemic colitis occurred. Finally, the patient was cured with ganciclovir. Follow-up sigmoidoscopy showed an improvement in ischemic colitis.
A 感染（CDI）是主要的医院获得性腹泻病之一。伪膜性结肠炎（PMC）是 CDI 的特征性内镜发现，表现为覆盖结肠黏膜的白色或黄白色斑块。缺血性结肠炎是结肠炎症的表现，表现为黏膜脱落和脆弱。缺血性结肠炎很少与 CDI 相关。当 CDI 并发其他引起腹泻的疾病时，治疗反应可能会延迟。到目前为止，CDI 并发巨细胞病毒（CMV）结肠炎的报告很少。本文报告了一例与 CDI 和 CMV 感染相关的 PMC 和缺血性结肠炎。在口服万古霉素和静脉甲硝唑治疗两周后，患者的腹泻并未改善。进行了随访乙状结肠镜检查，在发生缺血性结肠炎的广泛溃疡部位发现了 CMV 感染。最终，患者使用更昔洛韦治愈。随访乙状结肠镜检查显示缺血性结肠炎有所改善。
