Gastrointestinal Infections Caused by Cytomegalovirus

Cytomegalovirus (CMV) is an important human pathogen, causing a variety of syndromes ranging from asymptomatic infections to life-threatening end-organ disease. Infections of the gastrointestinal tract are an especially common form of disease caused by CMV and are usually manifest as luminal infections, such as esophagitis or colitis. Solid organ disease caused by CMV is also known to occur, with hepatitis being the most common syndrome. The large majority of cases of tissue-invasive disease caused by CMV have been reported to occur in immunocompromised hosts. Patients at highest risk for serious CMV-mediated disease are commonly HIV infected, recipients of transplants, or are receiving potent immunosuppressive medications. Intriguingly, several recent reports have discussed the previously underappreciated role of serious forms of CMV-mediated disease occurring in immunocompetent patients. This paper reviews several recent reports addressing important aspects related to the diagnosis, treatment, and management of CMV infections of the gastrointestinal tract.