Cytomegalovirus Colitis Following Azacitidine Therapy

Acta Oncologica, 2002

Cureus

Journal of Clinical Virology, 2008

Digestive Diseases and Sciences, 1999

Cytomegalovirus infection is usually reported inimmunocompromised patients. In this study, apparentlyimmunocompetent patients with cytomegaloviral colitiswere reviewed. Records with a diagnosis ofcytomegaloviral colitis from January 1989 to June 1996 wereretrieved for analysis. Ten patients were included(median age 70 yr). The major presenting symptoms werediarrhea and hematochezia. Ulceration was the mainmacroscopic finding. Rectal bleeding was mostlyself-limiting. Three patients developed localcomplications (rectovaginal fistula in two; rectalstricture in one). In the two patients with rectovaginalfistula, lymphocytes subsets and proliferative response wereentirely normal. In the other patient, low B lymphocytecount and low response to mitogen were demonstrated.However, the immunoglobulins were not suppressed and rectal biopsies revealed noncaseatinggranulomas, suggesting activated cell-mediated immunity.In conclusion, a high index of suspicion is crucial forearly diagnosis of cytomegaloviral colitis in patients with bloody diarrhea, even though obviousevidence of immunodeficiency is lacking.

The Israel Medical Association journal : IMAJ, 2018

An 85 year old female patient was admitted to our hospital with abdominal pain, watery diarrhea, vomiting, and fatigue. Significant medical history included diabetes mellitus, hypertension, chronic renal failure (pre-dialysis GFR < 10 ml/hr), and s/p cerebrovascular accident. The patient had no known history of immunodeficiency and had not received any immunosuppressive medications. Clinical examination revealed a diffuse abdominal tenderness but no signs of peritoneal irritation. Routine blood tests results showed leukocytosis (24 × 103, normal range [NR] 4–10 × 103) with neutrophilia (90%, NR 40–70%), thrombocytosis (869 × 103, NR 140–400 × 103), metabolic acidosis (pH 7.24, NR 7.38–7.42) with high anion gap (18.1, NR 8–16), normal lactate levels (1.38 mmol/L, NR 0.5–2.4), and high creatinine (520 micromol/L, NR 46–92). A computed tomography scan without intravenous contrast product showed notable thickening of the rectum to 2.5 cm, diffuse para-rectal fat blurring, and cecal t...

Clinical Medicine Insights: Case Reports, 2015

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