Presentation
We present the findings and review of the literature. [austinpublishinggroup.com]
We present a case of an 82-year-old immunocompetent man who presented with community-acquired bloody diarrhea. A computed tomography scan of the abdomen revealed pan-colitis. [ncbi.nlm.nih.gov]
Entire Body System
- Cape Verde
Case Report Here we present the case of a 70-year-old, melanodermic, female patient who is a native of Cape Verde but has been resident in Portugal since 1997. [karger.com]
- Refractory Anemia
We report the case of a 59-year-old woman treated for a refractory anemia with excess blasts (RAEB) who developed cytomegalovirus (CMV) colitis during induction therapy combining fludarabine, cytarabine and mitoxantrone. [ncbi.nlm.nih.gov]
- Recurrent Bacterial Infection
Although there was amelioration of the colitis and clinical status after treatment with ganciclovir, the patient later deteriorated and died due to recurrent bacterial infections. [ncbi.nlm.nih.gov]
Respiratoric
- Tachypnea
Clinical examination revealed tachycardia, tachypnea, a temperature of 38.3° C, and diffuse abdominal pain, combined with massive pain on rectal examination. [academic.oup.com]
Gastrointestinal
- Diarrhea
An 84-year-old male presented with chronic diarrhea and CMV colitis; he had been experiencing protracted diarrhea since 2006. In October 2009 he failed a 21-day course of valgancyclovir 900 mg orally twice daily. [ncbi.nlm.nih.gov]
- Chronic Diarrhea
Other pathogens should be considered in patients with chronic diarrhea who are refractory to initial treatments. [ncbi.nlm.nih.gov]
The infectious disease team was consulted and it was determined that in the context of the patient's HIV infection, AIDS and resultant immunosuppression, CMV infection was contributing to chronic diarrhea, abdominal pain, and formation of a colovesical [cureus.com]
Diagnostic Accuracy of Fecal Calprotectin Assay in Distinguishing Organic Causes of Chronic Diarrhea from Irritable Bowel Syndrome: A Prospective Study in Adults and Children. Clinical Chemistry 49:6 861–867. [labtestsonline.it]
It supports our policy of performing colonoscopy instead of flexible sigmoidoscopy in evaluation of HIV + patients with chronic unexplained diarrhea or gastrointestinal bleeding. [scielo.br]
- Chronic Watery Diarrhea
Chronic watery diarrhea was present in all the patients with colitis but was also present in 65% of the patients without colitis. [link.springer.com]
- Hyperactive Bowel Sounds
Physical exam revealed a cachectic male with hyperactive bowel sounds without any abdominal tenderness or organomegaly. [acgcasereports.gi.org]
- Rectal Mass
We report a case in which a previously healthy man presented with hematochezia and an obstructing rectal mass thought to be rectal adenocarcinoma. [acgcasereports.gi.org]
Workup
Workup for Clostridium difficile and all enteric pathogens were negative. The patient remained febrile with abdominal pain. [ncbi.nlm.nih.gov]
Coverage begins with the patient's first visit and proceeds through the diagnostic workup: endoscopy, radiologic testing, and instruments for rating and classifying inflammatory bowel disease. [books.google.de]
Workup revealed intussusception with associated pneumatosis. A right hemicolectomy was performed. Pathologic examination revealed cytomegalovirus (CMV) colitis. [austinpublishinggroup.com]
"Cytomegalovirus (CMV) Workup." Medscape.com. Dec. 1, 2017.. Azevedo, L.S., et al. "Cytomegalovirus infection in transplant recipients." Clinics (Sao Paulo) 70.7 July 2015: 515-23. doi: 10.6061/clinics/2015(07)09. Epub 2015 Jul 1. Review. [medicinenet.com]
X-Ray
- Pneumoperitoneum
[…] attempt at air contrast reduction in an immunosuppressed patient with such extensive pneumatosis was contraindicated and operative intervention was planned immediately A computed tomography (CT) scan of the abdomen and pelvis was performed to evaluate for pneumoperitoneum [austinpublishinggroup.com]
Abdominal CT showed a pneumoperitoneum, indicating perforation of the colon ( figure 1 A ), and the patient underwent emergency subtotal colectomy. [academic.oup.com]
Serum
- Microcytic Anemia
Blood investigations showed normal white cell count (5400/μL) with normal differential, microcytic anemia with hemoglobin 10 g/dL, and hypoalbuminemia with otherwise normal liver enzymes. [acgcasereports.gi.org]
Microbiology
- Staphylococcus Aureus
CASE PRESENTATION: We are presenting a 72-year-old African-American male transferred to our intensive care unit (ICU) with methicillin-resistant Staphylococcus aureus bacteremia, respiratory failure, and dialysis-dependent acute kidney injury. [ncbi.nlm.nih.gov]
Colonoscopy
- Colitis
Our experience suggests that biopsies may be necessary to detect CMV and the prompt management of CMV colitis should be instituted when intractable ischemic colitis is observed. [ncbi.nlm.nih.gov]
Other Pathologies
- Viral Inclusion Body
Light microscopy of selected viral diseases (morphology of viral inclusion bodies). Pathol Annu 1976;11:53-75. [ PUBMED ] 34. Schwartz DA, Wilcox CM. [jdeonline.in]
Treatment
Three weeks into treatment he continued with copious amounts of diarrhea, with no relief from loperamide, which was titrated from 2 mg/day to 2 mg every 6 hours. [ncbi.nlm.nih.gov]
Prognosis
Despite aggressive clinical manifestations, the prognosis of CMV colitis is good if diagnosed and treated early. [ncbi.nlm.nih.gov]
In patients without immunocompromised status, the prognosis appears to be age dependent, with patients older than 55 years having a higher mortality. Males and patients who need surgery also have a poorer prognosis. [emedicine.medscape.com]
Etiology
[…] the case of a patient who presented with abdominal pain 4 years after heart transplantation; clinical and x-ray findings were suggestive of a neoplastic or ischemic stenosis, and histopathological examination likewise initially suggested an ischemic etiology [ncbi.nlm.nih.gov]
Etiology Pathogen : cytomegalovirus ( CMV, human herpes virus 5, HHV-5 ) Transmission Blood transfusions Sexual transmission Droplet transmission Transplant-transmitted infection (e.g., bone marrow, lungs, kidneys) References: [1] [2] [3] Pathophysiology [amboss.com]
Physical exam is often not specific to the diagnosis of CMV colitis; fever in these patients can be indicative of an infectious etiology. [clinicaladvisor.com]
Etiology and management of toxic megacolon in patients with human immunodeficiency virus infection. Gastroenterology. 1994;107:858-63. [ Links ] 2. Bini EJ, Cohen J. [scielo.br]
(Etiology) Cytomegalovirus Gastroenteritis/Colitis disease is an indication of a frail immune system (which is caused by other medical conditions or viral infections). [dovemed.com]
Epidemiology
Search for other works by this author on: Ulrich von Both 1Division of Infectious Diseases and Hospital Epidemiology, Zurich, Switzerland Search for other works by this author on: Reto Laffer 1Division of Infectious Diseases and Hospital Epidemiology, [academic.oup.com]
Epidemiology Epidemiological data refers to the US, unless otherwise specified. [amboss.com]
Jeffrey D Band, MD, FACP, FIDSA Professor of Medicine, Oakland University William Beaumont School of Medicine; Health System Chair, Healthcare Epidemiology and International Medicine, Beaumont Health System; Former Chief of Infectious Diseases, Beaumont [emedicine.medscape.com]
[…] antiviral drugs, such as ganciclovir or valganciclovir Terminology CMV infection: refers to presence of detectable CMV levels in the human body CMV disease: CMV disease relates to symptoms due to CMV ICD coding B25.8: other cytomegaloviral diseases Epidemiology [pathologyoutlines.com]
Pathophysiology
Etiology Pathogen : cytomegalovirus ( CMV, human herpes virus 5, HHV-5 ) Transmission Blood transfusions Sexual transmission Droplet transmission Transplant-transmitted infection (e.g., bone marrow, lungs, kidneys) References: [1] [2] [3] Pathophysiology [amboss.com]
Infection can be acquired during birth, breast feeding, close contact, sexual contact, transfusion or with organ transplant (Scand J Gastroenterol 2010;45:1295) Sites Most common sites of CMV related gastrointestinal involvement are the esophagus and colon Pathophysiology [pathologyoutlines.com]
The pathophysiology of a disease may compromise the immune system. [journals.plos.org]
Pathophysiology Cytomegalovirus (CMV) has 3 major patterns of infection. [emedicine.medscape.com]
Prevention
Guidelines for the prevention and treatment of opportunistic infections in adults and adolescents with HIV: recommendations from the Centers for Disease Control and Prevention, the National Institutes of Health, and the HIV Medicine Association of the [karger.com]
Is it possible to prevent cytomegalovirus infection? Is there a CMV vaccine? Because CMV is a common virus, it is not always possible to prevent infection. Pregnant women should take precautions to prevent congenital CMV infection. [medicinenet.com]
European evidence-based consensus on the prevention, diagnosis and management of opportunistic infections in inflammatory bowel disease. J Crohns Colitis. 2009;3(2):47-91. [consultant360.com]