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Large bowel perforation secondary to CMV colitis: an unusual primary presentation of HIV infection
  1. Daniel Richard Barling1,
  2. Simon Tucker2,
  3. Haren Varia3,
  4. Peter Isaacs4
  1. 1A&E, Blackpool Victoria Hospital, Blackpool, UK
  2. 2Blackpool Teaching Hospitals NHS Foundation Trust, Blackpool, UK
  3. 3Department of Radiology, Blackpool Victoria Hospital, Blackpool, UK
  4. 4Department of Gastroenterology, Blackpool Victoria Hospital, Blackpool, UK
  1. Correspondence to Dr Daniel Richard Barling, dannybarling{at}


We report a case of HIV-associated Cytomegalovirus colitis complicated by large bowel perforation. A 62-year-old man of same-sex relationship was not known to have HIV, but a diagnosis of inflammatory bowel disease was made early in his admission, with steroid treatment initiated. He was later confirmed to be HIV positive, and found to have multiple microperforations of the bowel necessitating ileocecectomy and Hartmann's procedures.

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  • Contributors DRB was involved in the acute care of this patient working as an FY1 on medical nights, and subsequently followed up this patient's outcome to compile the case study. DRB and ST provided an acute medicine input and slant, with advice on the most relevant and applicable information from the case. HV selected appropriate images taken during the patients admission, detailing the findings shown. PI reviewed the final stages of the case report to ensure that necessary information had not been missed and that all key learning points were covered. This was particularly useful given that this patient had resided on PI's ward during their stay.

  • Competing interests None declared.

  • Patient consent Obtained.

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

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