Kotanagi H, Fukuoka T, Shibata Y, Yoshioka T, Aizawa O, Saito Y, Koyama K, Otaka M, Chiba M, Saito M
First Department of Surgery, Akita University School of Medicine, Japan.
J Gastroenterol. 1994 Aug;29(4):501-5. doi: 10.1007/BF02361250.
Cytomegalovirus (CMV) infection, which has been shown to complicate the course of ulcerative colitis (UC), has been implicated as a possible etiologic factor in the exacerbation of UC, especially in toxic megacolon. However, CMV infection in patients with UC accompanied by toxic megacolon has rarely been reported. Here we report a case of CMV infection of the colon accompanied by toxic megacolon occurring in UC. A 38-year-old woman had been treated with intravenous hydrocortisone, rectal steroid, and central venous alimentation for 6 weeks under the diagnosis of UC. She was transferred to Akita University Hospital because of increasing bloody diarrhea and abdominal pain. Toxic megacolon was identified by examinations on admission, and she underwent a total colectomy. Examination of the surgical specimen showed severe inflammation of the colon. Microscopically, cytomegalic inclusions were observed in and around the endothelial cells in the inflamed submucosal layer. It can be assumed that CMV infection was a secondary, opportunistic invader superimposed on UC, and that it played an important role in altering the clinical course of the patient.
巨细胞病毒（CMV）感染已被证明会使溃疡性结肠炎（UC）的病程复杂化，它被认为是UC病情加重的一个可能病因，尤其是在中毒性巨结肠中。然而，伴有中毒性巨结肠的UC患者的CMV感染鲜有报道。在此，我们报告1例发生于UC且伴有中毒性巨结肠的结肠CMV感染病例。一名38岁女性在UC诊断下接受了6周的静脉注射氢化可的松、直肠类固醇和中心静脉营养治疗。因便血和腹痛加重，她被转至秋田大学医院。入院检查发现中毒性巨结肠，随后她接受了全结肠切除术。手术标本检查显示结肠有严重炎症。显微镜下，在炎症黏膜下层的内皮细胞内及周围观察到巨细胞包涵体。可以推测，CMV感染是叠加在UC上的继发性机会性入侵者，并且在改变患者的临床病程中起了重要作用。
