PDF(Pubmed)
Abstract：
BACKGROUND: Cytomegalovirus infection manifests varying clinical characteristics and severity in diverse populations with different immune statuses. The signs and symptoms of gastrointestinal involvement are nonspecific. Here, we present a case of cytomegalovirus colitis in an immunocompetent adolescent, which manifested as intestinal pseud-obstruction.
METHODS: A 15-year-old man who had contracted novel coronavirus infection one month earlier was admitted to our hospital with fever, abdominal pain, and hematochezia. His abdomen was distended, and laboratory evaluation revealed a decrease in the blood count, an increase in inflammatory indicators and hepatic impairment. Imaging shows bowel wall thickening and dilatation of the colon. A diagnosis of intestinal infection combined with acute intestinal pseud-obstruction was made. Diarrhea persisted despite conservative treatment with empirical antibiotics. A colonoscopy was performed. Pathology confirmed cytomegalovirus infection. Ganciclovir therapy was initiated, and subsequent review showed a good recovery.
CONCLUSIONS: The case was diagnosed as cytomegalovirus colitis. We reviewed the reports of 9 cases of bowel obstruction, including our own, and found that the majority of the adult patients were elderly with underlying disease. Clinical and endoscopic manifestations are typically nonspecific, and imaging shows typical signs of intestinal obstruction. The final diagnosis was confirmed by pathology. Most of them have a good prognosis. We suggest that cytomegalovirus colitis can also lead to intestinal obstruction and that viral reactivation in immunocompetent individuals may be associated with inflammatory conditions and viral coinfection, particularly with the novel coronavirus.
METHODS: A 15-year-old man who had contracted novel coronavirus infection one month earlier was admitted to our hospital with fever, abdominal pain, and hematochezia. His abdomen was distended, and laboratory evaluation revealed a decrease in the blood count, an increase in inflammatory indicators and hepatic impairment. Imaging shows bowel wall thickening and dilatation of the colon. A diagnosis of intestinal infection combined with acute intestinal pseud-obstruction was made. Diarrhea persisted despite conservative treatment with empirical antibiotics. A colonoscopy was performed. Pathology confirmed cytomegalovirus infection. Ganciclovir therapy was initiated, and subsequent review showed a good recovery.
CONCLUSIONS: The case was diagnosed as cytomegalovirus colitis. We reviewed the reports of 9 cases of bowel obstruction, including our own, and found that the majority of the adult patients were elderly with underlying disease. Clinical and endoscopic manifestations are typically nonspecific, and imaging shows typical signs of intestinal obstruction. The final diagnosis was confirmed by pathology. Most of them have a good prognosis. We suggest that cytomegalovirus colitis can also lead to intestinal obstruction and that viral reactivation in immunocompetent individuals may be associated with inflammatory conditions and viral coinfection, particularly with the novel coronavirus.
摘要：
背景：巨细胞病毒感染在具有不同免疫状态的不同人群中表现出不同的临床特征和严重程度。胃肠道受累的体征和症状是非特异性的。这里,我们介绍了一个免疫功能正常的青少年巨细胞病毒性结肠炎的病例，表现为肠梗阻。
方法:1个月前感染新型冠状病毒感染的15岁男子因发烧入院,腹痛,和便血.他的腹部扩张，实验室评估显示血细胞计数下降，炎症指标和肝功能损害的增加。成像显示肠壁增厚和结肠扩张。诊断为肠道感染合并急性肠梗阻。尽管使用经验性抗生素进行保守治疗，但腹泻仍然存在。进行结肠镜检查。病理证实巨细胞病毒感染。更昔洛韦开始治疗，随后的审查显示恢复良好。
结论：该病例被诊断为巨细胞病毒性结肠炎。我们回顾了9例肠梗阻的报告。包括我们自己的,发现大多数成年患者是患有潜在疾病的老年人。临床和内镜表现通常是非特异性的，影像学显示肠梗阻的典型征象。最终诊断经病理证实。大多数患者预后良好。我们建议巨细胞病毒性结肠炎也可导致肠梗阻，免疫功能正常个体的病毒再激活可能与炎症和病毒感染有关。特别是新型冠状病毒。
方法:1个月前感染新型冠状病毒感染的15岁男子因发烧入院,腹痛,和便血.他的腹部扩张，实验室评估显示血细胞计数下降，炎症指标和肝功能损害的增加。成像显示肠壁增厚和结肠扩张。诊断为肠道感染合并急性肠梗阻。尽管使用经验性抗生素进行保守治疗，但腹泻仍然存在。进行结肠镜检查。病理证实巨细胞病毒感染。更昔洛韦开始治疗，随后的审查显示恢复良好。
结论：该病例被诊断为巨细胞病毒性结肠炎。我们回顾了9例肠梗阻的报告。包括我们自己的,发现大多数成年患者是患有潜在疾病的老年人。临床和内镜表现通常是非特异性的，影像学显示肠梗阻的典型征象。最终诊断经病理证实。大多数患者预后良好。我们建议巨细胞病毒性结肠炎也可导致肠梗阻，免疫功能正常个体的病毒再激活可能与炎症和病毒感染有关。特别是新型冠状病毒。
