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Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
[Cytomegalovirus colitis in an elderly polytraumatised patient]
R Wildenauer1, A-C Suttorp, P Kobbe
1Klinik für Unfallchirurgie, Universitätsklinikum Essen. wildenauer@foni.net
Deutsche Medizinische Wochenschrift (1946)
|November 7, 2008
Summary
Cytomegalovirus (CMV) colitis can cause severe gastrointestinal bleeding in immunocompromised patients. Early diagnosis and ganciclovir treatment are crucial for improving outcomes in elderly individuals.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Virology
Background:
- Cytomegalovirus (CMV) infections are common but can cause severe disease in immunocompromised individuals.
- Gastrointestinal bleeding in intensive care unit (ICU) patients can have various causes, making diagnosis challenging.
Observation:
- A polytraumatized elderly patient in the ICU developed severe hematochezia unresponsive to transfusions.
- Colonoscopy revealed multiple ulcers in the right colon and rectum, necessitating a right hemicolectomy.
- Histology confirmed intranuclear inclusions, and CMV-specific IgM and PCR tests were positive.
Findings:
- Antiviral therapy with ganciclovir resolved gastrointestinal symptoms post-surgery.
- Enteral alimentation was successfully resumed without complications.
- The case highlights CMV colitis as a critical differential diagnosis in severe GI bleeding.
Implications:
- CMV colitis should be suspected in immunocompromised patients with severe diarrhea or bleeding after excluding common causes.
- Prompt diagnosis and treatment are vital for better prognosis in elderly or comorbid patients.
- This case underscores the importance of considering opportunistic infections in critically ill patients.
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