Machens A, Bloechle C, Achilles E G, Bause H W, Izbicki J R
Department of General Surgery, University Hospital Eppendoft, University of Hamburg, Germany.
J Trauma. 1996 Apr;40(4):644-6. doi: 10.1097/00005373-199604000-00023.
Cytomegalovirus (CMV) colitis is a rare event that has been described mainly in immunocompromised patients with immunosuppressive medication or HIV infection. An association with severe trauma has not been described previously. We report a formerly healthy, multiply injured 75-year-old male who subsequently developed what appeared to be pseudomembranous colitis. By the time the diagnosis of toxic megacolon on the basis of CMV colitis was established, he had succumbed to multiple organ failure. Whenever pseudomembranous colitis is clinically suspected but not confirmed in a critically ill formerly healthy patient, CMV colitis should be excluded. Once the diagnosis is confirmed, generous resection of all affected colon is mandatory in view of the limited benefit of antiviral therapy in CMV-induced toxic megacolon.
巨细胞病毒（CMV）结肠炎是一种罕见疾病，主要见于接受免疫抑制治疗的免疫功能低下患者或感染HIV的患者。此前尚未报道过它与严重创伤有关。我们报告了一名75岁的既往健康、多处受伤的男性，他随后出现了疑似伪膜性结肠炎的症状。在基于CMV结肠炎确诊中毒性巨结肠时，他已死于多器官功能衰竭。对于临床怀疑为伪膜性结肠炎但未确诊的危重症既往健康患者，应排除CMV结肠炎。一旦确诊，鉴于抗病毒治疗对CMV诱导的中毒性巨结肠疗效有限，必须对所有受累结肠进行广泛切除。
