Diagnosis and Management of CMV Colitis

  • Anat Yerushalmy-Feler
  • Jacqueline Padlipsky
  • Shlomi CohenEmail author
Intra-Abdominal Infections, Hepatitis and Gastroenteritis (T. Steiner, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Intra-abdominal Infections, Hepatitis, and Gastroenteritis


Purpose of Review

Cytomegalovirus (CMV) colitis is a relatively common end-organ infectious complication in immunocompromised hosts which negatively affects clinical outcomes. This paper presents the contemporary approaches to the diagnosis and management of CMV colitis and discusses some of the controversies of this condition, focusing on methods of diagnosis.

Recent Findings

While certain risk factors for CMV colitis are well recognized, the clinical as well as endoscopic features of this condition are nonspecific. Rapid diagnosis and management are usually needed, especially in critically ill patients, which necessitate invasive diagnostic procedures. Hematoxylin and eosin staining of colonic mucosal tissue may show the typical viral inclusions associated with CMV colitis that are highly specific for this condition. However, the staining has low sensitivity compared to immunohistochemistry, which is considered the gold standard for diagnosis of CMV colitis. Tissue polymerase chain reaction (PCR) is highly sensitive for diagnosis, but is controversial for many reasons, detailed in this paper.


A high index of suspicion is needed, and once diagnosis is made, treatment should be highly considered to improve the outcome of these severely ill patients. Noninvasive diagnostic tests will be available in the future and will hopefully improve the diagnosis and care of patients with CMV colitis.


Colitis Cytomegalovirus Immunodeficiency Inflammatory bowel disease 





inflammatory bowel disease


ulcerative colitis


intensive care unit


human immunodeficiency virus




hematoxylin and eosin




polymerase chain reaction


formalin-fixed, paraffin-embedded tissue


Compliance with Ethical Standards

Conflict of Interest

All authors have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by anyof the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Anat Yerushalmy-Feler
    • 1
    • 2
  • Jacqueline Padlipsky
    • 2
  • Shlomi Cohen
    • 1
    • 2
    Email author
  1. 1.Pediatric Gastroenterology Unit, Pediatrics Department, “Dana-Dwek” Children’s HospitalTel Aviv Sourasky Medical CenterTel AvivIsrael
  2. 2.Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

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