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Pulmonary embolism in an immunocompetent patient with acute cytomegalovirus colitis.

Chou JW, Cheng KS - Intest Res (2016)

Bottom Line: Hence, such events are rarely reported in the literature.The patient subsequently experienced acute respiratory failure.The patient was successfully treated with intravenous administration of unfractionated heparin and intravenous ganciclovir.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, School of Medicine, China Medical University, Taichung, Taiwan, Republic of China.

ABSTRACT
Acute cytomegalovirus (CMV) infection occurs commonly in immunocompromised and immunocompetent patients, but is usually asymptomatic in the latter. Vascular events associated with acute CMV infection have been described, but are rare. Hence, such events are rarely reported in the literature. We report a case of pulmonary embolism secondary to acute CMV colitis in an immunocompetent 78-year-old man. The patient presented with fever and diarrhea. Colonic ulcers were diagnosed based on colonoscopy findings, and CMV was the proven etiology on pathological examination. The patient subsequently experienced acute respiratory failure. Pulmonary embolism was diagnosed based on the chest radiography and computed tomography findings. A diagnosis of acute CMV colitis complicated by pulmonary embolism was made. The patient was successfully treated with intravenous administration of unfractionated heparin and intravenous ganciclovir.

No MeSH data available.


Related in: MedlinePlus

Chest CT finding. Chest CT scan showed filling defects within the pulmonary trunk and main pulmonary arteries (arrows).
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Figure 3: Chest CT finding. Chest CT scan showed filling defects within the pulmonary trunk and main pulmonary arteries (arrows).

Mentions: However, 5 days post-colonoscopy, the patient experienced dyspnea and severe hypoxemia, necessitating emergent endotracheal intubation and ventilation. A chest radiograph obtained post-intubation revealed an engorged main pulmonary trunk with an abrupt cutoff of pulmonary vascularity in the distal portions bilaterally, indicative of the "Westermark sign" (Fig. 2, arrows). Subsequently, a CT scan of the chest was performed that showed several filling defects within the pulmonary trunk and main pulmonary arteries (Fig. 3). The patient was thus diagnosed as having pulmonary embolism.


Pulmonary embolism in an immunocompetent patient with acute cytomegalovirus colitis.

Chou JW, Cheng KS - Intest Res (2016)

Chest CT finding. Chest CT scan showed filling defects within the pulmonary trunk and main pulmonary arteries (arrows).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4863054&req=5

Figure 3: Chest CT finding. Chest CT scan showed filling defects within the pulmonary trunk and main pulmonary arteries (arrows).
Mentions: However, 5 days post-colonoscopy, the patient experienced dyspnea and severe hypoxemia, necessitating emergent endotracheal intubation and ventilation. A chest radiograph obtained post-intubation revealed an engorged main pulmonary trunk with an abrupt cutoff of pulmonary vascularity in the distal portions bilaterally, indicative of the "Westermark sign" (Fig. 2, arrows). Subsequently, a CT scan of the chest was performed that showed several filling defects within the pulmonary trunk and main pulmonary arteries (Fig. 3). The patient was thus diagnosed as having pulmonary embolism.

Bottom Line: Hence, such events are rarely reported in the literature.The patient subsequently experienced acute respiratory failure.The patient was successfully treated with intravenous administration of unfractionated heparin and intravenous ganciclovir.

View Article: PubMed Central - PubMed

Affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, School of Medicine, China Medical University, Taichung, Taiwan, Republic of China.

ABSTRACT
Acute cytomegalovirus (CMV) infection occurs commonly in immunocompromised and immunocompetent patients, but is usually asymptomatic in the latter. Vascular events associated with acute CMV infection have been described, but are rare. Hence, such events are rarely reported in the literature. We report a case of pulmonary embolism secondary to acute CMV colitis in an immunocompetent 78-year-old man. The patient presented with fever and diarrhea. Colonic ulcers were diagnosed based on colonoscopy findings, and CMV was the proven etiology on pathological examination. The patient subsequently experienced acute respiratory failure. Pulmonary embolism was diagnosed based on the chest radiography and computed tomography findings. A diagnosis of acute CMV colitis complicated by pulmonary embolism was made. The patient was successfully treated with intravenous administration of unfractionated heparin and intravenous ganciclovir.

No MeSH data available.


Related in: MedlinePlus