TY - JOUR T1 - Concomitant <em>Clostridium difficile</em> colitis and cytomegalovirus colitis in an immunocompetent elderly female JF - BMJ Case Reports DO - 10.1136/bcr-2012-007273 VL - 2012 SP - bcr2012007273 AU - Maria Kurtz AU - Mackenzie Morgan Y1 - 2012/12/12 UR - http://casereports.bmj.com/content/2012/bcr-2012-007273.abstract N2 - A 78-year-old Japanese woman with diarrhoea and abdominal pain was admitted for PCR test (PCR)-proven Clostridium difficile colitis. The patient's symptoms persisted despite multiple courses of antibiotics including intravenous metronidazole, oral  vancomycin and oral fidaxomicin. She underwent a stool transplant without improvement. Biopsies from a colonoscopy revealed concomitant cytomegalovirus (CMV) infection. The patient was immediately started on intravenous ganciclovir. Unfortunately, she developed sepsis secondary to colitis, and underwent definitive treatment with a total colectomy. Although CMV is a rare colonic pathogen in the immunocompetent patient, it should be considered in patients with severe or refractory C difficile colitis. ER -