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Case Report

Cytomegalovirus Colitis with Colon Perforation and Lower Gastrointestinal Bleeding in a Immunocompetent Patient

Sun Wook Kim, Yoon Jin Cha1, Min Hwan Kim, Moo-Nyun Jin, Jung-Hee Lee, Hye Jung Park, Sooyun Chang, Hyuk Lee2
The Ewha Medical Journal 2014;37(2):105-108. Published online: September 30, 2014

Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.

1Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.

2Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea.

Corresponding author: Hyuk Lee. Division of Gastroenterology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea. Tel: 82-2-3410-3409, Fax: 82-2-3410-6983, leehyuk@skku.edu
• Received: September 27, 2013   • Accepted: October 21, 2013

Copyright © 2014. Ewha Womans University School of Medicine

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Cytomegalovirus (CMV) infection in immunocompromised patients is associated with significant morbidity, mortality, and adverse clinical outcome. However, CMV infection in immunocompetent patients has been considered to have subclinical and self-limited course, and does not require treatment. We reports a case of CMV colitis, presented with colon perforation and lower gastrointestinal bleeding in a immunocompetent 31-year-old young male. After conservative treatment, colonoscopy revealed multiple ulcers in transverse colon. CMV colitis was confirmed by microscopic findings and immunohistochemistry. After successful treatment with ganciclovir, the patient improved without invasive procedure.
  • Keywords: Cytomegalovirus; Colitis; Immunocompetence
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Fig. 1
Abdominal computed tomography shows extraluminal air, wall defect, and pericolic fat infiltration (arrow) in distal transverse colon.
emj-37-105-g001.jpg
Fig. 2
Colonoscopic findings. (A) Well demarcated deep ulcer with white exudate in the transverse colon is shown. (B) Healing ulcer after two weeks of antiviral therapy is shown.
emj-37-105-g002.jpg
Fig. 3
Microscopic findings of the transverse colon. (A) Enlarged cell (arrow) in the stroma appears intranuclear inclusion (H&E, ×400). (B) Immunoshistochemical staining for CMV shows nuclear positivity in infected cell (×400).
emj-37-105-g003.jpg

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    Citations

    Citations to this article as recorded by  
    • Gastric Ulcers with Cytomegalovirus Infection in an Immunocompetent Patient
      Tae Oh Kim, Ki-Nam Shim, Sang Yoon Kim, Ji Young Lim, A Reum Choe, Chung Hyun Tae, Chang Mo Moon, Seong-Eun Kim, Hye-Kyung Jung, Sung-Ae Jung
      The Korean Journal of Helicobacter and Upper Gastrointestinal Research.2019; 19(4): 277.     CrossRef
    • Conservative treatment of cytomegalovirus colitis with bowel perforation in an immunocompetent patient: case report and review of literature
      Kyoung Sik Nam, Hee Ug Park, Min Gi Park, Su Ho Park, Ji Yeon Hwang, Dong Kyu Kim, Sung Jun Kim
      Yeungnam University Journal of Medicine.2017; 34(1): 75.     CrossRef

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    Cytomegalovirus Colitis with Colon Perforation and Lower Gastrointestinal Bleeding in a Immunocompetent Patient
    Ewha Med J. 2014;37(2):105-108.   Published online September 30, 2014
    DOI: https://doi.org/10.12771/emj.2014.37.2.105
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    Cytomegalovirus Colitis with Colon Perforation and Lower Gastrointestinal Bleeding in a Immunocompetent Patient
    Ewha Med J. 2014;37(2):105-108.   Published online September 30, 2014
    DOI: https://doi.org/10.12771/emj.2014.37.2.105
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    Cytomegalovirus Colitis with Colon Perforation and Lower Gastrointestinal Bleeding in a Immunocompetent Patient
    Image Image Image
    Fig. 1 Abdominal computed tomography shows extraluminal air, wall defect, and pericolic fat infiltration (arrow) in distal transverse colon.
    Fig. 2 Colonoscopic findings. (A) Well demarcated deep ulcer with white exudate in the transverse colon is shown. (B) Healing ulcer after two weeks of antiviral therapy is shown.
    Fig. 3 Microscopic findings of the transverse colon. (A) Enlarged cell (arrow) in the stroma appears intranuclear inclusion (H&E, ×400). (B) Immunoshistochemical staining for CMV shows nuclear positivity in infected cell (×400).

    Fig. 1

    Fig. 2

    Fig. 3

    Cytomegalovirus Colitis with Colon Perforation and Lower Gastrointestinal Bleeding in a Immunocompetent Patient
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