Coexisting Cytomegalovirus infection in immunocompetent patients with Clostridium difficile colitis

Publication date: Available online 12 January 2016 Source:Journal of Microbiology, Immunology and Infection Author(s): Khee-Siang Chan, Wen-Ying Lee, Wen-Liang Yu Cytomegalovirus (CMV) colitis usually occurs in the immunocompromised patients with human immunodeficiency virus infection, organ transplantation, and malignancy receiving chemotherapy or ulcerative colitis receiving immunosuppressive agents. However, CMV colitis is increasingly recognized in the immunocompetent hosts. Notably, CMV colitis coexisting with Clostridium difficile infection (CDI) in apparently healthy individuals has been published in recent years, which could result in high morbidity and mortality. CMV colitis is a rare but possible differential diagnosis in the immunocompetent patients with abdominal pain, watery or especially bloody diarrhea, which could be refractory to standard treatment for CDI. As a characteristic of CDI, however, pseudomembranous colitis may be only caused by CMV infection. Real-time CMV-PCR for blood and stool samples may be a useful and noninvasive diagnostic strategy to identify CMV infection when treatment of CDI eventually fails to show significant benefits. Quantitative CMV-PCR in mucosal biopsies may increase the diagnostic yield of traditional histopathology. CMV colitis is potentially life-threatening if severe complications occur, such as sepsis secondary to colitis, massive colorectal bleeding, toxic megacolon and colonic perforation, so that may necessity p...
Source: Journal of Microbiology, Immunology and Infection - Category: Microbiology Source Type: research