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被忽视的病原体:免疫功能正常患者的巨细胞病毒性结肠炎

The Overlooked Agent: Cytomegalovirus Colitis in an Immunocompetent Patient.

作者信息

Lagarto Margarida, Santos Ana, Freitas Bruno D, Anastácio Marta, Jesus Susana

机构信息

Medical Oncology, Centro Hospitalar de Lisboa Ocidental, Lisboa, PRT.

Internal Medicine, Centro Hospitalar de Lisboa Ocidental, Lisboa, PRT.

出版信息

Cureus. 2023 Mar 30;15(3):e36926. doi: 10.7759/cureus.36926. eCollection 2023 Mar.

Abstract

Cytomegalovirus (CMV) colitis is usually associated with immunosuppressed patients, which by the classic definition are individuals who have immunosuppressed associated conditions (human immunodeficiency virus [HIV], oncology diseases, inflammatory bowel disease, transplant patients) or who are submitted to immunosuppressing therapies (for instance, corticosteroids, chemotherapeutic agents or immunomodulation therapies). In immunocompetent patients, this diagnosis tends to be often missed, leading to a delay in initiating proper management. We present a case of a 91-year-old woman that was diagnosed with CMV colitis without any identified formal immunocompromising factors. We intend to highlight the need to review the definition of an immunosuppressed individual and emphasize that CMV colitis should be considered in the differential diagnosis, especially in elderly patients and those with underlying conditions that can possibly affect their immune status, since prompt diagnosis and treatment are essential and influence the prognosis.

摘要

巨细胞病毒(CMV)结肠炎通常与免疫抑制患者相关,按照经典定义,这些患者是患有免疫抑制相关疾病(人类免疫缺陷病毒[HIV]、肿瘤疾病、炎症性肠病、移植患者)或接受免疫抑制治疗(例如,皮质类固醇、化疗药物或免疫调节疗法)的个体。在免疫功能正常的患者中,这种诊断往往经常被漏诊,导致开始适当治疗的延迟。我们报告一例91岁女性患者,她被诊断为CMV结肠炎,但未发现任何明确的正式免疫受损因素。我们旨在强调需要重新审视免疫抑制个体的定义,并强调在鉴别诊断中应考虑CMV结肠炎,特别是在老年患者以及那些可能影响其免疫状态的基础疾病患者中,因为及时诊断和治疗至关重要且会影响预后。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd08/10148746/d4381bf4c86c/cureus-0015-00000036926-i01.jpg

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