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CMV enteritis causing hemorrhage and obstruction in an infant with AIDS
S E Dolgin1, J G Larsen, K D Shah
1Department of Surgery, City Hospital Center, Elmhurst, New York, NY.
Insights
Cytomegalovirus (CMV) enteritis caused severe gastrointestinal bleeding and fatal small bowel obstruction in an infant with acquired immunodeficiency syndrome (AIDS). This case highlights a distinct CMV enteritis presentation recognizable during surgery.
Area of Science:
- Pediatric Gastroenterology
- Infectious Diseases
- Virology
Background:
- Cytomegalovirus (CMV) infections frequently impact immunosuppressed individuals, particularly those with acquired immunodeficiency syndrome (AIDS).
- Gastrointestinal complications such as hemorrhage and perforation are common consequences of CMV infections in this population.
Observation:
- A critical case of CMV enteritis is presented in an infant diagnosed with AIDS.
- The infant experienced massive gastrointestinal hemorrhage and subsequently developed a fatal small bowel obstruction attributed to the infection.
Findings:
- Surgical examination revealed striking, diffuse yellowish plaques with central ulcerations throughout the small bowel.
- Biopsies confirmed the presence of cytomegalic inclusion bodies, indicative of CMV infection.
Implications:
- This case identifies a previously unrecognized form of CMV enteritis affecting infants.
- The distinct pathological findings are readily identifiable during laparotomy, aiding in diagnosis and management.
Abstract:
Serious gastrointestinal infections from cytomegalovirus (CMV) are often observed in immunosuppressed patients especially those with acquired immunodeficiency syndrome (AIDS). Hemorrhage and perforation have been frequent consequences. We present a case of CMV enteritis in an infant with AIDS who suffered massive hemorrhage and subsequent fatal small bowel obstruction from this condition. Gross findings at laparotomy were striking, diffuse, large yellowish plaques along the entire length of the small bowel. Each of these had a central ulceration. Each eventually caused a partial narrowing resulting in refractory small bowel obstruction. Biopsy of one of these lesions demonstrated many cells with typical cytomegalic inclusion bodies. This report illustrates a newly recognized type of CMV enteritis that can affect an infant and be readily recognized at laparotomy.