巨细胞病毒结肠炎一例报告：严重创伤后患者。
Cytomegalovirus Ileitis in a Patient With Post-severe Trauma: A Case Report.
机构信息
Department of Orthopedics, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, R.O.C.
Biotech Research and Innovation Centre, University of Copenhagen, Copenhagen, Denmark.
出版信息
In Vivo. 2024 Sep-Oct;38(5):2562-2564. doi: 10.21873/invivo.13731.
BACKGROUND/AIM: The mortality rate for alimentary tract hemorrhage remains high due to a variety of contributing factors. In this report, we present a case of post-severe trauma patient with life-threatening gastrointestinal bleeding caused by cytomegalovirus (CMV)-induced damage to the terminal ileum.
CASE REPORT
A 76-year-old female with a history of hypertension and gastrointestinal bleeding developed CMV ileitis post-severe trauma. Despite negative CMV IgM antibodies, PCR testing confirmed CMV infection in the biopsy tissue. Histopathological examination revealed viral inclusion bodies, with immunohistochemistry confirming CMV presence.
RESULTS
Intravenous ganciclovir effectively managed symptoms and halted bleeding. CMV ileitis, typically seen in immunocompromised states, may occur sporadically in immunocompetent individuals, including post-orthopedic surgery patients. The exact mechanism remains unclear, possibly related to surgical stress. Diagnosis relies on histopathology and immunohistochemistry.
CONCLUSION
Early recognition and treatment are vital for optimal outcomes, emphasizing the need for awareness among orthopedic surgeons regarding CMV as a potential cause of postoperative complications.
背景/目的：由于多种因素的影响，消化道出血的死亡率仍然很高。在本报告中，我们介绍了一例严重创伤后患者的病例，该患者因巨细胞病毒（CMV）引起的末端回肠炎而发生危及生命的胃肠道出血。
病例报告
一名 76 岁女性，有高血压和胃肠道出血病史，在严重创伤后发生 CMV 回肠炎。尽管 CMV IgM 抗体阴性，但 PCR 检测证实活检组织存在 CMV 感染。组织病理学检查显示病毒包涵体，免疫组化证实 CMV 存在。
结果
静脉用更昔洛韦有效控制了症状并停止了出血。CMV 回肠炎通常见于免疫功能低下的状态，但也可能在免疫功能正常的个体中偶发，包括骨科手术后患者。确切的机制尚不清楚，可能与手术应激有关。诊断依赖于组织病理学和免疫组化。
结论
早期识别和治疗对于获得最佳结果至关重要，这强调了骨科医生对 CMV 作为术后并发症潜在原因的认识的重要性。
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