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Rectal prolapse associated with cytomegalovirus pseudomembranous colitis in a child infected by human

Chitsanu Pancharoen1, Sasithorn Likitnukul, Voranush Chongsrisawat

  • 1Department of Pediatrics, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. chitsanu.p@chula.ac.th

The Southeast Asian Journal of Tropical Medicine and Public Health
|April 30, 2004
PubMed

Insights

A young girl with new HIV diagnosis experienced rectal prolapse due to cytomegalovirus (CMV) enterocolitis. This case highlights a rare presentation of CMV infection in pediatric HIV patients.

Area of Science:

  • Virology
  • Pediatric Gastroenterology
  • Infectious Diseases

Background:

  • Cytomegalovirus (CMV) is a common opportunistic infection in individuals with human immunodeficiency virus (HIV).
  • CMV enterocolitis typically presents with gastrointestinal symptoms, but unusual presentations can occur.
  • Early diagnosis and treatment are crucial for managing CMV infections in immunocompromised patients.

Observation:

  • A 4-year-old girl with newly diagnosed HIV presented with rectal prolapse.
  • Gross examination revealed multiple whitish punctate lesions in the rectal area.
  • Endoscopic evaluation showed shallow ulcers and pseudomembranes throughout the colon.

Findings:

  • Histopathological analysis of colonic biopsies confirmed the presence of CMV-like inclusion bodies.
  • Direct immunofluorescence assay using CMV-specific monoclonal antibodies positively identified CMV-infected cells in rectal smear specimens.
  • These findings establish a diagnosis of CMV enterocolitis.

Implications:

  • This case expands the spectrum of clinical presentations for CMV enterocolitis in pediatric HIV.
  • Rectal prolapse should be considered as a potential, albeit rare, symptom of CMV enterocolitis in this population.
  • Highlights the importance of prompt diagnostic workup, including viral detection, in immunocompromised children with atypical gastrointestinal symptoms.

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