Han K J, Jung I S, Kim C K, Park S K, Kim D W, Baick S H, Won J H, Hong D S, Hwang S D, Moon C, Park H S
Department of Internal Medicine, Soonchunhyang University College of Medicine, Seoul, Korea.
Korean J Intern Med. 1998 Jul;13(2):143-6. doi: 10.3904/kjim.1998.13.2.143.
CMV infection may occur anywhere in the gastrointestinal tract. Among the small intestine, ileum is the most common site of CMV disease and infection of jejunum is a rare one in patients with CMV gastroenteritis. Although rare, the reason why the recognition of this diagnosis is important is that it cause the lethal hemorrhage and perforation of gastrointestinal tract when its diagnosis and treatment was delayed. Rapid diagnosis are able to using the immunohistochemical stain in shell vial culture of infected specimen or peripheral neutrophils preparation in viremic patients within 8 to 36 hours. The treatment of choice is antiviral agent or surgical resection. We experienced a case of CMV disease of jejunum in patient with non-Hodgkin's lymphoma who showed severe ulceration in jejunum and massive intestinal hemorrhage, and he survived after successful treatment with segmental resection of jejunum and intravenous ganciclovir.
巨细胞病毒(CMV)感染可发生于胃肠道的任何部位。在小肠中,回肠是CMV疾病最常见的部位,而空肠感染在CMV胃肠炎患者中较为罕见。尽管罕见,但认识到这一诊断很重要的原因是,若诊断和治疗延误,它会导致胃肠道致命性出血和穿孔。在感染标本的空斑试验培养中使用免疫组化染色或对病毒血症患者的外周中性粒细胞制备物进行检测,能够在8至36小时内实现快速诊断。治疗的选择是抗病毒药物或手术切除。我们遇到一例非霍奇金淋巴瘤患者发生空肠CMV疾病,该患者空肠出现严重溃疡和大量肠道出血,经空肠节段切除和静脉注射更昔洛韦成功治疗后存活。