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Cytomegalovirus colitis in the immunocompetent host: an overview
E Klauber1, L E Briski, R Khatib
1Department of Medicine, St John Hospital and Medical Center, Detroit, Michigan 48236, USA.
Scandinavian Journal of Infectious Diseases
|May 4, 1999
Summary
Cytomegalovirus (CMV) colitis is a rare but severe condition in immunocompetent individuals, presenting with diarrhea and bleeding. Diagnosis requires biopsy, and the efficacy of antiviral therapy remains uncertain.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pathology
Background:
- Cytomegalovirus (CMV) colitis is an uncommon condition that can affect immunocompetent individuals.
- It can arise from primary infection or reactivation of the virus.
- Understanding its clinical presentation and outcomes is crucial for patient management.
Observation:
- This study reviewed 15 cases of CMV colitis in immunocompetent patients, including 2 new cases.
- Patients were categorized into older individuals with reactivation (mean age 69.1 years) and younger patients with primary infection (mean age 43.9 years).
- Common symptoms included diarrhea (86.7%), fever (80.0%), gastrointestinal bleeding (66.7%), and abdominal pain (60.0%).
Findings:
- Endoscopic findings revealed erosive colitis with multiple or single ulcers.
- Biopsy was diagnostic in 92.3% of cases.
- Complications such as massive hemorrhage, toxic megacolon, and perforation occurred in 13.3% of patients, while 20.0% experienced protracted inflammatory bowel disease, exclusively in primary infection cases.
- The overall mortality rate was 26.7%.
Implications:
- CMV colitis in immunocompetent hosts is a severe, erosive disease with significant morbidity.
- Early diagnosis through histopathological examination is essential.
- Further research is needed to determine the efficacy of antiviral therapy in this population.