Cytomegalovirus Colitis Mimicking Ulcerative Colitis Flare in an Immunocompromised Patient: A Challenging Diagnosis

This case report details a 40-year-old male patient with a background of ulcerative colitis (UC), who presented with persistent bloody diarrhea refractory to standard treatment. The clinical picture was initially suggestive of a UC flare-up, prompting the continued use of immunosuppressive therapy. However, histopathological evaluation ultimately revealed cytomegalovirus (CMV) colitis, a condition that can mimic UC exacerbation but requires a distinct treatment approach. The patient's immunosuppressive therapy, essential for UC management, likely contributed to the reactivation of latent CMV infection, underscoring the complexity of managing such cases. This case underscores the critical importance of a multidisciplinary approach in differentiating between UC exacerbation and opportunistic infections such as CMV colitis, especially in immunocompromised patients.