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Yale J Biol Med. 1996 Jul-Aug; 69(4): 323–328.
PMCID: PMC2589048

Cytomegalovirus infection masquerading as an ulcerative colitis flare-up: case report and review of the literature.

Abstract

We report the case of a patient with a case of cytomegalovirus (CMV) colitis, which presented as a flare-up of her ulcerative colitis. Standard treatment for the flare-up, which included intravenous corticosteroids, bowel rest, topical salicylates and ultimately colectomy were not effective. The patient did not improve until therapy with intravenous ganciclovir was initiated. There have been 26 previous reports of CMV colitis complicating inflammatory bowel disease (IBD). The diagnosis is not frequently entertained and, if not made, leads to a high rate of colectomy (67 percent) and mortality (33 percent). Appropriate antiviral therapy appears to eliminate these complications, thus a high index of suspicion for CMV superinfection in cases of IBD refractory to traditional therapy is warranted.

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Selected References

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  • Goodgame RW. Gastrointestinal cytomegalovirus disease. Ann Intern Med. 1993 Nov 1;119(9):924–935. [PubMed]
  • Loftus EV, Jr, Alexander GL, Carpenter HA. Cytomegalovirus as an exacerbating factor in ulcerative colitis. J Clin Gastroenterol. 1994 Dec;19(4):306–309. [PubMed]
  • Berk T, Gordon SJ, Choi HY, Cooper HS. Cytomegalovirus infection of the colon: a possible role in exacerbations of inflammatory bowel disease. Am J Gastroenterol. 1985 May;80(5):355–360. [PubMed]
  • Orvar K, Murray J, Carmen G, Conklin J. Cytomegalovirus infection associated with onset of inflammatory bowel disease. Dig Dis Sci. 1993 Dec;38(12):2307–2310. [PubMed]
  • Eyre-Brook IA, Dundas S. Incidence and clinical significance of colonic cytomegalovirus infection in idiopathic inflammatory bowel disease requiring colectomy. Gut. 1986 Dec;27(12):1419–1425. [PMC free article] [PubMed]
  • POWELL RD, WARNER NE, LEVINE RS, KIRSNER JB. Cytomegalic inclusion disease and ulcerative colitis; report of a case in a young adult. Am J Med. 1961 Feb;30:334–340. [PubMed]
  • Sidi S, Graham JH, Razvi SA, Banks PA. Cytomegalovirus infection of the colon associated with ulcerative colitis. Arch Surg. 1979 Jul;114(7):857–859. [PubMed]
  • WONG TW, WARNER NE. Cytomegalic inclusion disease in adults. Report of 14 cases with review of literature. Arch Pathol. 1962 Nov;74:403–422. [PubMed]
  • Keren DF, Milligan FD, Strandberg JD, Yardley JH. Intercurrent cytomegalovirus colitis in a patient with ulcerative colitis. Johns Hopkins Med J. 1975 Apr;136(4):178–182. [PubMed]
  • Dent DM, Duys PJ, Bird AR, Birkenstock WE. Cytomegalic virus infection of bowel in adults. S Afr Med J. 1975 Apr 12;49(16):669–672. [PubMed]
  • Cooper HS, Raffensperger EC, Jonas L, Fitts WT., Jr Cytomegalovirus inclusions in patients with ulcerative colitis and toxic dilation requiring colonic resection. Gastroenterology. 1977 Jun;72(6):1253–1256. [PubMed]
  • Guttman D, Raymond A, Gelb A, Ehya H, Mather U, Mildvan D, Spigland I. Virus-associated colitis in homosexual men: two case reports. Am J Gastroenterol. 1983 Mar;78(3):167–169. [PubMed]
  • Diepersloot RJ, Kroes AC, Visser W, Jiwa NM, Rothbarth PH. Acute ulcerative proctocolitis associated with primary cytomegalovirus infection. Arch Intern Med. 1990 Aug;150(8):1749–1751. [PubMed]
  • Ng IO, Ng M. Colonic malacoplakia: unusual association with ulcerative colitis. J Gastroenterol Hepatol. 1993 Jan-Feb;8(1):110–115. [PubMed]
  • Lortholary O, Perronne C, Leport J, Leport C, Vildé JL. Primary cytomegalovirus infection associated with the onset of ulcerative colitis. Eur J Clin Microbiol Infect Dis. 1993 Jul;12(7):570–572. [PubMed]
  • Farmer GW, Vincent MM, Fuccillo DA, Horta-Barbosa L, Ritman S, Sever JL, Gitnick GL. Viral investigations in ulcerative colitis and regional enteritis. Gastroenterology. 1973 Jul;65(1):8–18. [PubMed]
  • Bernades P, Nataf C, Ferchal F, Colimon R. Etude du taux des anticorps anticytomégalovirus chez des malades atteints de rectocolite hémorragique ou de maladie de Crohn. Etude coopérative du Groupe de Recherches sur les Entérocolites Cryptogénétiques (GREC). Gastroenterol Clin Biol. 1980 Feb;4(2):128–133. [PubMed]
  • van Dorp WT, Jonges E, Bruggeman CA, Daha MR, van Es LA, van Der Woude FJ. Direct induction of MHC class I, but not class II, expression on endothelial cells by cytomegalovirus infection. Transplantation. 1989 Sep;48(3):469–472. [PubMed]
  • Iwamoto GK, Monick MM, Clark BD, Auron PE, Stinski MF, Hunninghake GW. Modulation of interleukin 1 beta gene expression by the immediate early genes of human cytomegalovirus. J Clin Invest. 1990 Jun;85(6):1853–1857. [PMC free article] [PubMed]
  • VOGEL FS. Enhanced susceptibility of proliferating endothelium to salivary gland virus under naturally occurring and experimental conditions. Am J Pathol. 1958 Nov-Dec;34(6):1069–1079. [PubMed]

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