Acute CMV-Colitis in a Patient with a History of Ulcerative Colitis

Area of Science:

• Gastroenterology
• Virology
• Immunology

Background:

• Symptomatic cytomegalovirus (CMV) infections typically affect immunocompromised individuals, including those with debilitating diseases, transplant recipients, and patients with acquired immunodeficiency syndrome (AIDS).
• Gastrointestinal CMV infections, particularly colitis, are uncommon in immunocompetent individuals, with most cases reported in immunocompromised populations.

Purpose of the Study:

• To report a case of cytomegalovirus (CMV) causing colitis in a young female patient with a history of ulcerative colitis (UC).
• To discuss the relationship between CMV infection and inflammatory bowel diseases (IBD), particularly in light of its potential pathogenicity in immunocompromised patients.

Main Methods:

• Diagnosis of CMV infection was confirmed by detecting CMV early antigen, antibodies, and viral presence in the colonic mucosa.
• The patient received a combined treatment regimen including anti-inflammatory and antiviral medications.

Main Results:

• The patient, a young female with a history of ulcerative colitis (UC), presented with an acute attack of colitis attributed to CMV infection.
• Following combined anti-inflammatory and antiviral treatment, the patient achieved a complete recovery.

Conclusions:

• Cytomegalovirus (CMV) can cause symptomatic colitis in immunocompetent patients, including those with underlying inflammatory bowel diseases like ulcerative colitis (UC).
• This case underscores the importance of considering CMV as a potential cause of colitis exacerbations in patients with IBD, irrespective of their immune status.
• Combined anti-inflammatory and antiviral therapy can be effective in managing CMV colitis in this patient population.