Pedicelli Alessandro, Zoughlami Amine, Aleynikova Olga, Greenaway Christina, Miller Corey
Department of Medicine, Division of Gastroenterology and Hepatology, Jewish General Hospital, McGill University, Montreal, Québec, Canada.
Department of Pathology, McGill University, Montreal, Québec, Canada.
ACG Case Rep J. 2025 May 2;12(5):e01682. doi: 10.14309/crj.0000000000001682. eCollection 2025 May.
We report a rare case of cytomegalovirus (CMV) colitis presenting radiologically as acute appendicitis in an immunocompetent 71-year-old man known for ulcerative colitis. Although initial imaging revealed acute appendicitis, a lack of clinical improvement with antibiotic therapy prompted further evaluation with colonoscopy, which led to the diagnosis of CMV colitis on a background of mild ulcerative colitis flare. Most individuals infected by CMV will exhibit lifelong latency; however, the virus can reactivate under impaired immune status (eg, transplant recipients, those receiving immunosuppressive therapy). Patients with underlying inflammatory bowel disease are especially at risk of CMV colitis during an acute flare. This case illustrates a unique presentation of CMV colitis in an immunocompetent host, with initial imaging studies revealing acute appendicitis.
我们报告了一例罕见的巨细胞病毒（CMV）结肠炎病例，该病例在影像学上表现为急性阑尾炎，患者是一名71岁免疫功能正常的男性，患有溃疡性结肠炎。尽管最初的影像学检查显示为急性阑尾炎，但抗生素治疗后临床症状未改善，促使进一步进行结肠镜检查，结果在轻度溃疡性结肠炎发作的背景下诊断出CMV结肠炎。大多数感染CMV的个体将表现为终身潜伏；然而，该病毒可在免疫状态受损时重新激活（如移植受者、接受免疫抑制治疗者）。患有潜在炎症性肠病的患者在急性发作期间尤其有患CMV结肠炎的风险。本病例说明了CMV结肠炎在免疫功能正常宿主中的独特表现，最初的影像学研究显示为急性阑尾炎。
