Abstract
Cytomegalovirus (CMV) infection is associated with significant morbidity and mortality in immunocompromised patients. In immunocompetent individuals, the infection is usually subclinical but it can sometimes be life threatening. We describe a case of fatal CMV proctitis in a 71-year-old man following an Ivor–Lewis esophagectomy. After surgery he developed renal failure, methicillin-resistant Staphylococcus aureus pneumonia, and acute respiratory distress syndrome. He recovered but developed melena and massive fresh rectal bleeding. Sigmoidoscopy revealed severe proctitis and a biopsy was consistent with ischemia. Despite undergoing a proctectomy he continued to bleed and died despite every effort. The final histological examination of the rectum revealed a CMV infection.
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H Stein SD Slek (1965) ArticleTitleThe incidence of infection with cytomegalovirus in a normal population: a serological study in Greater London J Hyg 63 79–87 Occurrence Handle10.1017/S0022172400044983
JS Speigel AD Schwabe (1980) ArticleTitleDisseminated cytomegalovirus infection with gastrointestinal involvement. The role of altered immunity in the elderly Am J Gastroenterol 73 37–44
KL Ng H Jean HS Ng W Luman (2003) ArticleTitleGastrointestinal cytomegalovirus infection in non-human immunodeficiency virus infected patients Med J Malaysia 58 IssueID3 337–44 Occurrence Handle14750372 Occurrence Handle1:STN:280:DC%2BD2c%2FkvF2rsA%3D%3D
D Henson (1972) ArticleTitleCytomegalovirus inclusion bodies in the gastrointestinal tract Arch Pathol 93 477–82 Occurrence Handle4337090 Occurrence Handle1:STN:280:DyaE387otFWmtA%3D%3D
A Machens C Bloechle EG Achilles HW Bause JR Isbicki (1996) ArticleTitleToxic megacolon caused by cytomegalovirus colitis in multiple injury patients J Trauma 40 644–6 Occurrence Handle8614049 Occurrence Handle1:STN:280:DyaK287osF2ksw%3D%3D Occurrence Handle10.1097/00005373-199604000-00023
S Bang YB Park BS Kang MC Park HK Kim SK Lee (2004) ArticleTitleCMV enteritis causing ileal perforation in underlying lupus enteritis Clin Rheumatol 23 69–72 Occurrence Handle14749990 Occurrence Handle10.1007/s10067-003-0825-z
CS Lee AH Low PT Ender HC Bodenheimer (2004) ArticleTitleCytomegalovirus colitis in an immunocompetent patient with amoebiasis: case report and review of the literature Mount Sinai J Med 71 IssueID5 347–50
Y Takahashi T Tange (2004) ArticleTitlePrevalence of cytomegalovirus infection in inflammatory bowel disease patients Dis Colon Rectum 47 IssueID5 722–6 Occurrence Handle15037934 Occurrence Handle10.1007/s10350-003-0117-3
K Takeuchi Y Tsuzuki T Ando M Sekihara T Hara Y Ohno et al. (2001) ArticleTitleClinical characteristics of acute haemorrhagic rectal ulcers J Clin Gastroenterol 33 IssueID3 226–8 Occurrence Handle11500613 Occurrence Handle10.1097/00004836-200109000-00012 Occurrence Handle1:STN:280:DC%2BD3MvlsFSgsA%3D%3D
CA Tsneg LT Chen KB Tsai YC Su DC Wu CM Jan et al. (2004) ArticleTitleAcute haemorrhagic rectal ulcer syndrome: A new clinical entity? Report of 19 cases and review of the literature Dis Colon Rectum 47 895–905 Occurrence Handle10.1007/s10350-004-0531-1
HJ Choi EJ Shin YH Hwang EG Weiss JJ Nogueras SD Wexner (2005) ArticleTitleClinical presentation and surgical outcome in patients with solitary rectal ulcers syndrome Surg Innov 12 IssueID4 307–13 Occurrence Handle16424950 Occurrence Handle10.1177/155335060501200404
YS Kang MA Kamm AF Engel IC Talbot (1996) ArticleTitlePathology of the rectal wall in solitary rectal ulcer syndrome and complete rectal ulcer prolapse Gut 38 587–90 Occurrence Handle8707093 Occurrence Handle1:STN:280:DyaK28zjslWlsQ%3D%3D
KI Maull WK Kinning S Kay (1982) ArticleTitleStercoral ulceration Am J Surg 48 IssueID1 20–4 Occurrence Handle1:STN:280:DyaL387lvVGntQ%3D%3D
H Shinkawa Yasuhara S Naka H Yanagie T Nojiri Y Furuya et al. (2003) ArticleTitleFactors affecting the early mortality of patients with non-traumatic colorectal perforation Surg Today 33 13–7 Occurrence Handle12560901 Occurrence Handle10.1007/s005950300002
Y Tokunaga K Hata R Nishitai J Kaganoi H Nanbu K Ohsumi (1998) ArticleTitleSpontaneous perforation of the rectum with possible stercoral etiology: report of a case and review of the literature Surg Today 28 937–9 Occurrence Handle9744404 Occurrence Handle10.1007/s005950050256 Occurrence Handle1:STN:280:DyaK1cvhsFKmsQ%3D%3D
AS Puri JC Vij A Chaudhary N Kumar A Sachdev V Malhotra et al. (1996) ArticleTitleDiagnosis and outcome of isolated rectal tuberculosis Dis Col Rectum 39 IssueID10 1126–9 Occurrence Handle10.1007/BF02081413 Occurrence Handle1:STN:280:DyaK28vivVChtw%3D%3D
GP Mueller RA Williams (1995) ArticleTitleSurgical infections in AIDS patients Am J Surg 169 IssueIDsuppl 375–85
ZD Goodman JK Boitnott JH Yardley (1979) ArticleTitlePerforation of the colon associated with cytomegalovirus infection Dig Dis Sci 24 376–80 Occurrence Handle222560 Occurrence Handle10.1007/BF01297124 Occurrence Handle1:STN:280:DyaE1M3htlSksg%3D%3D
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Alam, I., Shanoon, D., Alhamdani, A. et al. Severe Proctitis, Perforation, and Fatal Rectal Bleeding Secondary to Cytomegalovirus in an Immunocompetent Patient: Report of a Case. Surg Today 37, 66–69 (2007). https://doi.org/10.1007/s00595-006-3335-1
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DOI: https://doi.org/10.1007/s00595-006-3335-1