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CMV enteritis causing massive intestinal hemorrhage in an elderly patient.

Morunglav M, Theate I, Bertin G, Hantson P - Case Rep Med (2010)

Bottom Line: The patient died from unrelated complications.Discussion.Aging could be accompanied by a relative immune weakness and specific antiviral therapy seems to be indicated.

View Article: PubMed Central - PubMed

Affiliation: Department of Intensive Care, Cliniques St-Luc, Université Catholique de Louvain, 1200 Brussels, Belgium.

ABSTRACT
Background. Cytomegalovirus (CMV) disease is rare in previously immunocompetent patients. We report a case of CMV enteritis complicated by massive intestinal bleeding. Case History. A 72-year-old immunocompetent patient was admitted for diarrhea and abdominal pain. Aspecific pattern of duodenitis was found at abdomen computed tomography and on biopsies during endoscopy. A diagnosis of vasculitis was suspected on the basis of the clinical and biological course (skin lesions, arthralgias, proteinuria, low complement C3 and C4 fractions, etc.) and pulse steroid therapy was prescribed. The patient developed multiple episodes of intestinal bleeding with shock and required urgent laparotomy. Jejunitis due to CMV vasculitis was proven by histological examination of the operative specimen. Treatment with ganciclovir was initiated. No bleeding recurrence was noted. No other lesions from CMV infection were observed. The patient died from unrelated complications. Discussion. CMV enteritis is a rare cause of intestinal bleeding particularly in previously immunocompetent patients. Aging could be accompanied by a relative immune weakness and specific antiviral therapy seems to be indicated.

No MeSH data available.


Related in: MedlinePlus

Abdomen computed tomography after intravenous contrast. Significant thickening of the Treitz angle and proximal jejunum (arrows), with infiltration of the loco-regional fat.
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fig1: Abdomen computed tomography after intravenous contrast. Significant thickening of the Treitz angle and proximal jejunum (arrows), with infiltration of the loco-regional fat.

Mentions: The patient was investigated by abdomen computed tomodensitometry (CT) and upper and lower endoscopy. The abdomen CT with intravenous contrast disclosed a significant thickening of the wall of the third, fourth duodenum, and of the proximal part of the jejunum with infiltration of the loco-regional fat (Figure 1).


CMV enteritis causing massive intestinal hemorrhage in an elderly patient.

Morunglav M, Theate I, Bertin G, Hantson P - Case Rep Med (2010)

Abdomen computed tomography after intravenous contrast. Significant thickening of the Treitz angle and proximal jejunum (arrows), with infiltration of the loco-regional fat.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2913790&req=5

fig1: Abdomen computed tomography after intravenous contrast. Significant thickening of the Treitz angle and proximal jejunum (arrows), with infiltration of the loco-regional fat.
Mentions: The patient was investigated by abdomen computed tomodensitometry (CT) and upper and lower endoscopy. The abdomen CT with intravenous contrast disclosed a significant thickening of the wall of the third, fourth duodenum, and of the proximal part of the jejunum with infiltration of the loco-regional fat (Figure 1).

Bottom Line: The patient died from unrelated complications.Discussion.Aging could be accompanied by a relative immune weakness and specific antiviral therapy seems to be indicated.

View Article: PubMed Central - PubMed

Affiliation: Department of Intensive Care, Cliniques St-Luc, Université Catholique de Louvain, 1200 Brussels, Belgium.

ABSTRACT
Background. Cytomegalovirus (CMV) disease is rare in previously immunocompetent patients. We report a case of CMV enteritis complicated by massive intestinal bleeding. Case History. A 72-year-old immunocompetent patient was admitted for diarrhea and abdominal pain. Aspecific pattern of duodenitis was found at abdomen computed tomography and on biopsies during endoscopy. A diagnosis of vasculitis was suspected on the basis of the clinical and biological course (skin lesions, arthralgias, proteinuria, low complement C3 and C4 fractions, etc.) and pulse steroid therapy was prescribed. The patient developed multiple episodes of intestinal bleeding with shock and required urgent laparotomy. Jejunitis due to CMV vasculitis was proven by histological examination of the operative specimen. Treatment with ganciclovir was initiated. No bleeding recurrence was noted. No other lesions from CMV infection were observed. The patient died from unrelated complications. Discussion. CMV enteritis is a rare cause of intestinal bleeding particularly in previously immunocompetent patients. Aging could be accompanied by a relative immune weakness and specific antiviral therapy seems to be indicated.

No MeSH data available.


Related in: MedlinePlus