Korean J Gastroenterol.  1998 Aug;32(2):184-195.

Efficacy of the Treatment with Antiviral Agents in the Cytomegalovirus Infection of the Gastrointestinal Test

• Song IS
• Choi KW
• Kim CY
• Jung HC
• Kim TH
• Kim YS
• Kim JS
• Lee CH

Abstract

BACKGROUND AND AIMS: Cytomegalovirus (CMV) infection of the gastrointestinal (GI) tract can cause serious diseases in immunocompromised patients. The use of antiviral agent has improved the prognosis of CMV infection of the GI tract. This study was performed to find out the clinical features of CMV infection of the GI tract and to evaluate the efficacy of antiviral therapy.
METHODS
We analyzed 18 patients with CMV infection of the GI tract diagnosed by histopathology and immunohistochemistry.
RESULTS
GI symptoms were hematochezia, diarrhea and abdominal pain in colitis, substernal pain and odynophagia in esophagitis, and epigastric pain and vomiting in gastritis. Endoscopic examination showed multiple large well-demarcated ulcers (78%), erosion, hyperemia and mucosal edema. Histo- pathologic examination disclosed basophilic intranuclear inclusions (33%), intracytoplasmic inclusions and cytomegalic cells. Serum CMV IgM ELISA positivity rate was 39%. Twelve patients were treated with antiviral agents (ganciclovir;11, acyclovir;1). Clinical improvement was noticed in 83% of the cases. Although most of the immunocompromised patients were improved by antiviral agents, one suffered a relapse and three died of other opportunistic infections.
CONCLUSIONS
Immunohistochemical staining was recommended to enhance the sensitivity of histopathologic analysis in case of suspicious CMV infection. Antiviral agents were effective in the treatment of CMV infection in immunocompromised hosts.

Keyword

Cytomegalovirus; Inclusion body; Immunohistochemistry; Antiviral agents

MeSH Terms

Abdominal Pain
Antiviral Agents*
Basophils
Colitis
Cytomegalovirus Infections*
Cytomegalovirus*
Diarrhea
Edema
Enzyme-Linked Immunosorbent Assay
Esophagitis
Gastritis
Gastrointestinal Hemorrhage
Gastrointestinal Tract
Humans
Hyperemia
Immunocompromised Host
Immunoglobulin M
Immunohistochemistry
Inclusion Bodies
Intranuclear Inclusion Bodies
Opportunistic Infections
Prognosis
Recurrence
Ulcer
Vomiting
Antiviral Agents
Immunoglobulin M