Related Experiment Videos
Cytomegalovirus as an exacerbating factor in ulcerative colitis
E V Loftus1, G L Alexander, H A Carpenter
1Division of Gastroenterology and Internal Medicine, Mayo Clinic and Foundation, Rochester, Minnesota 55905.
Journal of Clinical Gastroenterology
|December 1, 1994
Summary
Cytomegalovirus (CMV) colitis is a rare but treatable cause of severe ulcerative colitis flares. Prompt diagnosis and treatment with ganciclovir can help avoid colectomy in patients with inflammatory bowel disease.
Area of Science:
- Gastroenterology
- Virology
- Immunology
Background:
- Cytomegalovirus (CMV) colitis is infrequently diagnosed in inflammatory bowel disease (IBD) patients, typically those on immunosuppressants.
- This case highlights CMV colitis in an ulcerative colitis patient on sulfasalazine monotherapy.
Observation:
- A 39-year-old male with ulcerative colitis presented with viral prodrome and bloody diarrhea.
- Endoscopy revealed severe colitis; the patient initially worsened despite steroids and antibiotics.
Findings:
- Biopsies showed characteristic CMV inclusions, confirming CMV colitis.
- Serologic studies indicated recent CMV infection.
- Intravenous ganciclovir and a steroid taper led to clinical improvement, avoiding colectomy.
Implications:
- CMV colitis is a critical, treatable differential diagnosis in IBD flares, even without traditional immunosuppression.
- Early antiviral therapy can prevent severe complications and colectomy.
- This case underscores the importance of considering viral etiologies in refractory colitis.