Korean J Gastroenterol.  2012 Apr;59(4):303-307. 10.4166/kjg.2012.59.4.303.

A Case of Cytomegalovirus Colitis with Endoscopic Finding Resembling Crohn's Disease

Affiliations
  • 1Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. DRYOUN@yuhs.ac
  • 2Department of Pathology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Abstract

Cytomegalovirus (CMV) colitis is common among immunocompromised patients, and often diagnosed by pathologic confirmation because it is associated with a diverse spectrum of clinical and endoscopic features. However, Crohn's disease has no definitive diagnostic criteria, but longitudinal ulcers and cobble stone appearance are accepted as typical endoscopic features of Crohn's disease. An 83 year-old male with a history of radiotherapy for hypopharyngeal cancer visited our hospital with a complaint of melena for 1 week. His colonoscopic exam showed multiple longitudinal ulcers along the entire colon. Most of the ulcers were longer than 4 cm, these endoscopic findings were suspected as typical endoscopic features of Crohn's disease. Pathologic reports revealed multiple inclusion bodies with CMV on immunohistochemistry. He was finally diagnosed as having CMV colitis, and received a 3 week-course of intravenous ganciclovir. A colonoscopic follow-up showed complete healing of the multiple longitudinal ulcers, and he is doing well now without further treatment.

Keyword

Cytomegalovirus colitis; Longitudinal ulcer; Crohn's disease

MeSH Terms

Aged, 80 and over
Antiviral Agents/therapeutic use
Colitis/*diagnosis/etiology/pathology
Colonoscopy
Crohn Disease/diagnosis
Cytomegalovirus Infections/*diagnosis/drug therapy/pathology
Ganciclovir/therapeutic use
Humans
Immunohistochemistry
Injections, Intravenous
Male
Tomography, X-Ray Computed
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