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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

Histopathological findings. (A) Histological examination of biopsy specimens showed cytomegalic cells in the epithelium. The cells had large, densely stained nuclei and intranuclear inclusion bodies (arrows) on H&E (magnification, ×400). (B) Immunohistochemical analysis showed positive reaction for monoclonal anti-cytomegalovirus antibodies (arrows; magnification, ×400).
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Figure 4: Histopathological findings. (A) Histological examination of biopsy specimens showed cytomegalic cells in the epithelium. The cells had large, densely stained nuclei and intranuclear inclusion bodies (arrows) on H&E (magnification, ×400). (B) Immunohistochemical analysis showed positive reaction for monoclonal anti-cytomegalovirus antibodies (arrows; magnification, ×400).

Mentions: Histological evaluation of the colonic biopsy specimens revealed cytomegalic cells with densely staining nuclei and intranuclear inclusion bodies in the epithelium (Fig. 4A, arrows). These epithelial cells were positive for monoclonal anti-CMV antibody on immunohistochemical analysis, indicative of CMV infection (Fig. 4B, arrows). Based on these pathological features, a diagnosis of CMV colitis was made.


Pulmonary embolism in an immunocompetent patient with acute cytomegalovirus colitis.

Chou JW, Cheng KS - Intest Res (2016)

Histopathological findings. (A) Histological examination of biopsy specimens showed cytomegalic cells in the epithelium. The cells had large, densely stained nuclei and intranuclear inclusion bodies (arrows) on H&E (magnification, ×400). (B) Immunohistochemical analysis showed positive reaction for monoclonal anti-cytomegalovirus antibodies (arrows; magnification, ×400).
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Figure 4: Histopathological findings. (A) Histological examination of biopsy specimens showed cytomegalic cells in the epithelium. The cells had large, densely stained nuclei and intranuclear inclusion bodies (arrows) on H&E (magnification, ×400). (B) Immunohistochemical analysis showed positive reaction for monoclonal anti-cytomegalovirus antibodies (arrows; magnification, ×400).
Mentions: Histological evaluation of the colonic biopsy specimens revealed cytomegalic cells with densely staining nuclei and intranuclear inclusion bodies in the epithelium (Fig. 4A, arrows). These epithelial cells were positive for monoclonal anti-CMV antibody on immunohistochemical analysis, indicative of CMV infection (Fig. 4B, arrows). Based on these pathological features, a diagnosis of CMV colitis was made.

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