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Case Reports: Unusual presentation of more common disease/injury
Cytomegaloviral colitis in primary CMV viraemia in a young immunocompetent adult
  1. William King1,
  2. Raymond Richhart1,
  3. David Hernandez Gonzalo2 and
  4. Ellen Zimmermann3
  1. 1Internal Medicine, University of Florida, Gainesville, Florida, USA
  2. 2Pathology, University of Florida, Gainesville, Florida, USA
  3. 3Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, FL, USA
  1. Correspondence to Dr William King; william.king{at}medicine.ufl.edu

Abstract

A man in his 20s presented with a 2-week history of fever, fatigue and diarrhoea. On arrival to the emergency department, he had clinical findings of sepsis. The care team initially suspected sepsis secondary to bacterial colitis and administered antibiotics. Further workup including a stool PCR assay for gastrointestinal pathogens failed to establish a diagnosis, and he had no evidence of immune compromise. Colonoscopy revealed mucosal ulceration presumed to be ulcerative colitis. Histopathology obtained after discharge revealed severe colitis with cytomegalovirus (CMV) inclusions. Serological studies indicated a primary CMV infection. To our knowledge, this is the first report of a primary CMV infection presenting as severe colitis and systemic disease in a young immunocompetent patient without underlying disease.

  • infection (gastroenterology)
  • ulcerative colitis
  • hepatitis and other GI infections

https://doi.org/10.1136/bcr-2022-249891

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    Footnotes

    • Correction notice Spelling of last name of author Ellen Zimmermann has been corrected since the article was published online.

    • Contributors WK and RR wrote the manuscript. DHG obtained and analysed pictures of the histopathology and assisted with formulating the text. EZ performed literature review and manuscript editing, and was the primary attending physician and the project leader.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.