Korean J Gastroenterol.  2002 Jan;39(1):59-63.

Cytomegalovirus Ileitis Manifested by Severe Bleeding in an Immunocompetent Individual

• Kim EK
• Myung SJ
• Yang SK
• Jung HY
• Chang HS
• Jang G
• Jung YH
• Hong WS
• Kim JH
• Min YI

Abstract

Cytomegalovirus (CMV) infections are usually reported in immunocompromised patients. However, it occurs rarely in immunocompetent individuals. We report a case of 64-year-old male patient who was immunocompetent and developed massive lower gastrointestinal bleeding. Colonoscopic examination showed normal except for bleeding coming from terminal ileum. Angiography revealed active bleeding from distal ileum and the bleeding was controlled by coil embolization. However, three days later, hematochezia redeveloped. To control persistent bleeding, we resected a large ileal ulcer, which proved to be an isolated ulcer containing cells with CMV inclusion bodies. In the reported case of massive lower gastrointestinal bleeding related to CMV ulceration, the site of hemorrhage was usually the cecum rather than the small intestine. This case suggests that hemorrhage due to CMV infection of the ileum may occur in immunocompetent host without endoscopic evidence of colonic involvement.

Keyword

Cytomegalovirus; Ileal ulcer; Immunocompetent

MeSH Terms

Angiography
Cecum
Colon
Cytomegalovirus*
Embolization, Therapeutic
Gastrointestinal Hemorrhage
Hemorrhage*
Humans
Ileitis*
Ileum
Immunocompromised Host
Inclusion Bodies
Intestine, Small
Male
Middle Aged
Ulcer