Cytomegalovirus Proctitis in A Diabetic Patient

Abstract

Cytomegalovirus (CMV) colitis is thought to occur almost exclusively in immunosup-pressed persons. Here we describe an unusual case of CMV proctitis in an 82-year-old male patient with diarrhea and uncontrolled diabetes mellitus, who had urinary tract infection and not received immunosuppressive therapy. Colonoscopy showed large ulcerations and sinus tracts involving the rectum. Improvement of proctitis was noted after treatment with Ganciclovir. CMV is a DNA virus and a member of the herpesvirus group. After an initial infection, the genome of the virus persists in the host and may later spontaneously become reactivated under conditions of immune compromise. Clinical significant CMV infections are usually found in patients in whom immunologic mechanisms have been altered or suppressed by neoplasia, chronic infections, immunosuppressive therapy, or AIDS^1. Alimentary tract CMV infections were reported as a first manifestation in acquired immunodeficiency syndrome^2. A few such occurrences have been reported in patients with diabetes mellitus(superscript 3,4). We here report the case of an elderly HI V-negative man with CMV proctitis diagnosed by the presence of CMV inclusions in biopsy specimens of the rectum.