Skip to main content

Advertisement

SpringerLink
Log in

Zytomegalievirusinfektion als Ursache von Darmperforationen

Cytomegalovirus infection of the intestine as a cause of perforations

  • Kasuistiken
  • Published:
Klinische Wochenschrift Aims and scope Submit manuscript

Summary

Three male patients with the acquired immunodeficiency syndrome revealed perforations of the intestine (jejunum-ileum; colon ascendens; coecum). The cause was necrosis due to cytomegalovirus infection. The characteristic findings were cytomegalic inclusion bodies in endothelial cells of the capillaries. These lesions caused alterations of the microcirculation. Therefore it seems reasonable to conclude that in these cases necrosis and perforation were due to ischemia. Cytomegalovirus infection must be taken into consideration in any patient with the acquired immunodeficiency syndrome and gastrointestinal ulcerations.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

CT:

Computertomogramm

HIV:

Human immunodeficiency virus

H.-E.-Färbung:

Hämatoxylin-Eosin-Färbung

Literatur

  1. Bach M, Bagwell SP, Knapp NP, Davis KM, Hedstrom PS (1985) 9-(1,3-dihydroxy-2-propoxymethyl) guanine for cytomegalovirus infections in patients with the acquired immunodeficiency Syndrome. Ann Intern Med 103:381–382

    Google Scholar 

  2. Blumberg RS, Kelsey P, Perrone T, Diersin R, Laquaglia M, Ferruci J (1984) Cytomegalovirus- and cryptosporidium-associated acalcaleulous gangrenous cholecystitis. Am J Med 76:1118–1123

    Google Scholar 

  3. Campbell DA, Piercey JRA, Shnitka TK, Goldsand G, Devine RDO, Weinstein WM (1977) Cytomegalovirus associated gastric ulcer. Gastroenterology 72:533–535

    Google Scholar 

  4. Cooper HS, Raffensberger EC, Jonas L, Fitts WT (1977) Cytomegalovirus inclusions in patients with ulcerative colitis and toxic dilation requiring colonic resection. Gastroenterology 72:1253–1256

    Google Scholar 

  5. Dörfler H, Hehlmann R, Zoller WG, Goebel FD (1987) Bronchoskopischer Nachweis der Pneumocystis-carinii-Pneumonie. Med Klin 82:515–517

    Google Scholar 

  6. Doerr HW, Braun R, Munk K (1985) Human cytomegalovirus infection: Recent developments in diagnosis and epidemiology. Klin Wochenschr 63:241–251

    Google Scholar 

  7. Drew WL, Mills J, Levy J, Dylewski J, Casavant C, Amann AJ, Brochie H, Merigan T (1985) Cytomegalovirus infection and abnormal T-lymphocyte subset ratios in homosexual men. Ann Intern Med 103:61–63

    Google Scholar 

  8. Emanuel C, Peppard J, Stover D, Gold J, Armstrong D, Hammerling M (1986) Rapid immunodiagnosis of cytomegalovirus pneumonia by bronchalveolar lavage using human and murine monoclonal antibodies. Ann Intern Med 104:476–481

    Google Scholar 

  9. Felsenstein D, d'Amico DJ, Hirsch MS, Neumeyer DA, Cederberg DM, de Miran da Paulo, Schooley RT (1985) Treatment of Cytomegalovirus retinitis with 9-(2-hydroxy-1-(hydroxymethyl)ethoxymethyl) guanine. Ann Intern Med 103:377–380

    Google Scholar 

  10. Foucar E, Mukai K, Foucar K, Sutherland DER, van Buren Ch T (1981) Colon ulceration in lethal Cytomegalovirus infection. Am J Clin Pathol 76:788–801

    Google Scholar 

  11. Gertler SL, Pressman J, Price P, Brozinsky S, Miyai K (1983) Gastrointestinal cytomegalovirus infection in homosexual man with severe acquired immunodeficiency syndrome. Gastroenterology 85:1403–1406

    Google Scholar 

  12. Goodman D, Porter D (1973) Cytomegalovirus vasculitis with fatal colonic hemorrhage. Arch Pathol 96:281–284

    Google Scholar 

  13. Gorelkin L, Chandler FW, Ewing EP (1986) Staining qualities of cytomegalovirus inclusions in the lungs of patients with the acquired immunodeficiency syndrome: A potential source of diagnostic misinterpretation. Hum Pathol 17:926–929

    Google Scholar 

  14. Jeantils V, Lemaitre MO, Robert J, Gondonen Y, Krivitzky A, Dekant G (1986) Subacute polyneuropathy with encephalopathy in AIDS with human cytomegalovirus pathogenicity? Lancet II 1986:1039

    Google Scholar 

  15. Knapp AB, Horst DA, Eliopoulos G, Gramm HA, Gaber LW, Falchuk KR, Falchuk LM, Trey C (1983) Widespread cytomegalovirus gastroenterocolitis in a patient with acquired immunodeficiency syndrome. Gastroenterology 85:1399–1402

    Google Scholar 

  16. Kodama T, Fukuda S, Takino T, Omary Y, Oka T (1985) Gastroduodenal cytomegalovirus infection after renal transplantation — fiberscopic observations. Endoscopy 17:157–158

    Google Scholar 

  17. Macher AM, Reichert CM, Straus SE, Longo DL, Pavillo J, Lane HC, Fauci AS, Rook AH, Manischewik JF, Oniman GV (1983) Death in the AIDS patient: Role of cytomegalovirus. N Engl J Med 309:1454

    Google Scholar 

  18. Meiselman MS, Cello JP, Margareten W (1985) Cytomegalovirus Colitis-report of the clinical, endoscopic and pathologic findings in two patients with the acquired immune deficiency syndrome. Gastroenterology 88:171–175

    Google Scholar 

  19. Mössner J, Fischbach W, Meyer P (1986) Gastrointestinale Infektionen bei Immunsuppression. Med Klin 81:351–356

    Google Scholar 

  20. Myerson D, Hackman RC, Nelson JA, Ward DC, McDougall JK (1984) Widespread presence of histologically occult cytomegalovirus. Hum Pathol 15:430–439

    Google Scholar 

  21. Neumann-Haefelin D (1986) Cytomegalievirus-Infektion. Dtsch Med Wochenschr 111:1251–1257

    Google Scholar 

  22. Onge GS, Bezahler GH (1982) Giant esophageal ulcer associated with cytomegalovirus. Gastroenterology 83:127–130

    Google Scholar 

  23. Reed EC, Dandliker PS, Meyers JD (1986) Treatment of cytomegalovirus pneumonia with 9-(2-hydroxy-1-(hydroxymethyl)ethoxymethyl) guanine and high-dose corticosteroids. Ann Intern Med 105:214–215

    Google Scholar 

  24. Rotterdam H (1986) Die Pathologie des Verdauungstraktes bei AIDS. Pathologe 7:310–317

    Google Scholar 

  25. Sheep DH, Dandliker PS, de Miranda P, Burnette TC, Cederberg DM, Kirk LE, Meyers JD (1985) Activity of 9-(2-hydroxy-1-(hydroxymethyl)ethoxymethyl) guanine in the treatment of cytomegalovirus pneumonia. Ann Intern Med 103:368–373

    Google Scholar 

  26. Souza Andrade de J, Bambirra EA, Lima GF, Moreira EF, de Oliveira CA (1983) Gastric cytomegalic inclusion bodies diagnosed by histologic examination of endoscopic biopsies in patients with gastric ulcer. Am J Clin Pathol 79:493–496

    Google Scholar 

  27. Villar LA, Massanari RM, Mitros FA (1984) Cytomegalovirus infection with acute erosive esophagitis. Am J Med 76:924–928

    Google Scholar 

  28. Weinstein L, Edelstein SM, Madara JL, Falchuk KR, McManus BM, Trier JS (1981) Intestinal cryptosporidiasis complicated by disseminated cytomegalovirus infection. Gastroenterology 81:584–591

    Google Scholar 

  29. Wolfe BM, Cerry JD (1973) Hemorrhage from cecal ulcers of cytomegalovirus infection. Ann Surg 177:490–494

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Medizinische Poliklinik, der Universität München, Germany

    H. Dörfler, C. Eisenhut & -D. -D. Goebel

  2. Chirurgische Poliklinik, der Universität München, Germany

    K. Geißler

  3. Pathologisches Institut, der Universität München, Germany

    K. Remberger

Authors
  1. H. Dörfler
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. C. Eisenhut
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. K. Geißler
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. K. Remberger
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. -D. -D. Goebel
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Dörfler, H., Eisenhut, C., Geißler, K. et al. Zytomegalievirusinfektion als Ursache von Darmperforationen. Klin Wochenschr 66, 69–74 (1988). https://doi.org/10.1007/BF01713014

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01713014

Key words

Search

Navigation