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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

Microscopic examination (hematoxylin-eosin, x150) of the operative specimen. Ulcerative ileitis, the mucosa is replaced by a granulation tissue.
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fig3: Microscopic examination (hematoxylin-eosin, x150) of the operative specimen. Ulcerative ileitis, the mucosa is replaced by a granulation tissue.

Mentions: Histology of the jejunal resection showed a severe mucosal necrosis with loss of villi (Figure 3). High-power examination revealed thrombosis and fibrinoid necrosis suggestive of vasculitis. Some of the endothelial cells presented the characteristic cytopathogenic aspect of CMV infection (Figure 4).


CMV enteritis causing massive intestinal hemorrhage in an elderly patient.

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

Microscopic examination (hematoxylin-eosin, x150) of the operative specimen. Ulcerative ileitis, the mucosa is replaced by a granulation tissue.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig3: Microscopic examination (hematoxylin-eosin, x150) of the operative specimen. Ulcerative ileitis, the mucosa is replaced by a granulation tissue.
Mentions: Histology of the jejunal resection showed a severe mucosal necrosis with loss of villi (Figure 3). High-power examination revealed thrombosis and fibrinoid necrosis suggestive of vasculitis. Some of the endothelial cells presented the characteristic cytopathogenic aspect of CMV infection (Figure 4).

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