Cytomegalovirus colitics in a normal woman

Abstract

A-32-year-old woman was admitted to our hospital because of diarrhea, fever, and liver dysfunction. IgM antibody to hepatitis A, hepatitis C antibody and hepatitis B makers were negative. Antibodies to human dificiency virus was negative. Bacterial cultures of the stool were negative. Sigmoidscopy on the 9th hospital day showed diffuse edematous and imflated mucosa in the rectum and left-sided colon. Multiple erosions and small ulcers were also present. Polymerase chain reaction examination revealed cytomegalovirus (CMV) DNA in the biopsy specimen of the rectum and the blood on the 10lh hospital day. IgG antibody titer to CMV was low, but IgM titer was high. Her physical state had improved and fever resolved without anti-CMV therapy. Second sigmoidscopy on the 24th hospital day showed normal mucosa. One month later the patient was free from any symptoms. Immunocompromised patients such as recipients of solid organ and bone marrow transplants, patients with AIDS, and patients with malignancies frequently complicate CMV colitis, which can be a major cause of death. Thus, CMV colitis is rarely overlooked in immunocompromised patients. Only a few cases of CMV colitis are reported in adult patients with no risk for CMV infection or associated disease. CMV colitis should be concluded in the differential diagnosis of acute or subacute colitis even in immunocompetent patints. © 1997, The Japan Society for Clinical Immunology. All rights reserved.