Korean J Gastrointest Endosc.  2007 Aug;35(2):110-115.

Acute Cytomegalovirus Proctocolitis Presenting with Massive Lower Gastrointestinal Bleeding

• Rhie SY
• Choi CH
• Lee HW
• Do MY
• Lee SH
• Heo C
• Kim SW
• Kim HJ
• Chang SK
• Lee TJ
• Oh HE

Abstract

Cytomegalovirus (CMV) colitis usually affects immunosuppressed patients. However, CMV colitis may also affect patients with a debilitation caused by a severe illness or affect patients that have a specific physiological status (old age, pregnancy). Clinically, patients with CMV colitis most commonly present with abdominal pain, diarrhea, and gastrointestinal bleeding. The diagnosis of CMV colitis usually requires a biopsy of mucosal tissue. The characteristic finding on biopsy reveals CMV inclusion bodies. CMV colitis can be successfully treated with ganciclovir. We report two cases of CMV proctocolitis in elderly patients with chronic diseases that presented with massive lower gastrointestinal bleeding due to multiple rectal ulcerations. A pathological examination showed CMV inclusion bodies. CMV colitis should be considered in the differential diagnosis of patients with massive rectal ulcer bleeding when other causes fail to explain the course of the disease.

Keyword

Cytomegalovirus; Colitis; Bleeding

MeSH Terms

Abdominal Pain
Aged
Biopsy
Chronic Disease
Colitis
Cytomegalovirus*
Diagnosis
Diagnosis, Differential
Diarrhea
Ganciclovir
Hemorrhage*
Humans
Inclusion Bodies
Mucous Membrane
Proctocolitis*
Ulcer
Ganciclovir