Abstract
Cytomegalovirus infection is usually reported inimmunocompromised patients. In this study, apparentlyimmunocompetent patients with cytomegaloviral colitiswere reviewed. Records with a diagnosis ofcytomegaloviral colitis from January 1989 to June 1996 wereretrieved for analysis. Ten patients were included(median age 70 yr). The major presenting symptoms werediarrhea and hematochezia. Ulceration was the mainmacroscopic finding. Rectal bleeding was mostlyself-limiting. Three patients developed localcomplications (rectovaginal fistula in two; rectalstricture in one). In the two patients with rectovaginalfistula, lymphocytes subsets and proliferative response wereentirely normal. In the other patient, low B lymphocytecount and low response to mitogen were demonstrated.However, the immunoglobulins were not suppressed and rectal biopsies revealed noncaseatinggranulomas, suggesting activated cell-mediated immunity.In conclusion, a high index of suspicion is crucial forearly diagnosis of cytomegaloviral colitis in patients with bloody diarrhea, even though obviousevidence of immunodeficiency is lacking.
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Ng, FH., Chau, TN., Cheung, TC. et al. Cytomegalovirus Colitis in Individuals Without Apparent Cause of Immunodeficiency. Dig Dis Sci 44, 945–952 (1999). https://doi.org/10.1023/A:1026604529393
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DOI: https://doi.org/10.1023/A:1026604529393