Abstract
Purpose. Cytomegalovirus (CMV) colitis usually occurs in patients with inflammatory bowel disease (IBD) or those who are immunocompromised. However, clinical manifestations, endoscopic appearance and the clinical course vary. This report presents our experience with diagnosis and treatment of CMV colitis at the Kaohsiung Veterans General Hospital.Methods. Twenty-two patients, from 2001 to 2011, with CMV colitis were retrospectively analyzed. Their underlying comorbidities, endoscopic findings, treatment and outcomes were assessed.Results. Most patients were older than 60 years old. Common comorbidities included cardiovascular disease, pulmonary disease and sepsis. Most patients presented with diarrhea; others presented with fever, abdominal pain and hematochezia. All patients were diagnosed with immunohistochemistry (IHC). Colitis with or without ulcer was the most common endoscopic appearance. Eighteen patients received antiviral therapy and 12 of them had symptomatic relief. Three patients who underwent surgery eventually expired.Conclusion. CMV colitis can present with variable clinical manifestations. Full-length colonoscopy and tissue biopsy confirmation with immunohistochemical stain is required to diagnose CMV colitis in most cases. Antiviral therapy is still the mainstay of treatment. The prognosis of such patients is closely related to their underlying comorbidities. Early recognition and a high degree of suspicion of this clinical entity is needed to ensure a better prognosis of the patients.
Published Version
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