CMV colitis
Background
- CMV is part of the Herpesviridae family
- 50-80% of the world's population is seropositive for CMV
- Causes a mild or undetectable infection in immunocompetent hosts
- Severe systemic illness is found in immunosuppressed hosts
Clinical Features
- Fever
- Anorexia
- Malaise
- Abdominal pain, Abdominal distention, constipation
- Nausea/vomiting
- Chronic watery diarrhea
- Bloody diarrhea
- Worsening symptoms of inflammatory bowel disease
- Weight loss
- Dehydration
Differential Diagnosis
Colitis
- Viral gastroenteritis
- Bacterial gastroenteritis
- Campylobacter infections
- Clostridium difficile colitis
- Colon cancer
- Crohn disease
- Cryptosporidiosis
- Mycobacterium Avium-Intracellulare
- Toxic megacolon
- Ulcerative colitis
- Ischemic bowel disease (e.g. mesenteric ischemia, strangulated hernia)
- Pseudomembranous enterocolitis
- Lymphoma
- Ileocecal amebiasis
- Sarcoidosis
- Yersinia
- Campylobacter
Management
- Ganciclovir 5mg/kg IV q12hrs x 21 days (or until resolution of symptoms)
- Foscarnet 90mg/kg IV q12hrs daily x 21 days (or until resolution of symptoms)
See Also
References
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