Skip to main content
Top
Published in: BMC Gastroenterology 1/2020

Open Access 01-12-2020 | Eosinophilia | Case report

Colon perforation due to cytomegalovirus infection in a patient with idiopathic hypereosinophilic syndrome: a case report

Authors: Bin Luo, Chengxin Deng, Tieying Hou, Fangping Xu, Qianchao Liao, Yong Li, Junjiang Wang

Published in: BMC Gastroenterology | Issue 1/2020

Login to get access

Abstract

Background

Hypereosinophilic syndrome (HES) is a very rare disease and usually treated with corticosteroids. Gastrointestinal (GI) cytomegalovirus (CMV) infection is also rare but frequent in patients with immunocompromised status. These two related diseases present with similar manifestations, and may result in a life-threatening complication: perforation. However, the treatment strategies differ greatly. Here, we report a case of colon perforation due to cytomegalovirus infection in a patient with idiopathic HES.

Case presentation

A 41-year-old man with a history of HES was transferred to our hospital due to an acute onset of abdominal pain. During the treatment course of HES, this patient received CMV-DNA test with a result of < 2000 copies/ml. Computed tomography (CT) suggested colon perforation. An emergency surgery was performed immediately. Pathological diagnosis revealed CMV infection and infiltration of eosinophils. This patient received both anti-CMV therapy and immunosuppression therapy. Subsequently, the patient recovered and was discharged 25 days after the operation.

Conclusion

During the course of HES treatment, CMV infection should be reconsidered if digestive symptoms relapse.
Literature
1.
go back to reference Gotlib J. World Health Organization-defined eosinophilic disorders: 2015 update on diagnosis, risk stratification, and management. Am J Hematol. 2015;90:1077–89.CrossRef Gotlib J. World Health Organization-defined eosinophilic disorders: 2015 update on diagnosis, risk stratification, and management. Am J Hematol. 2015;90:1077–89.CrossRef
2.
go back to reference Crane MM, Chang CM, Kobayashi MG, et al. Incidence of myeloproliferative hypereosinophilic syndrome in the United States and an estimate of all hypereosinophilic syndrome incidence. J Allergy Clin Immunol. 2010;126:179–81.CrossRef Crane MM, Chang CM, Kobayashi MG, et al. Incidence of myeloproliferative hypereosinophilic syndrome in the United States and an estimate of all hypereosinophilic syndrome incidence. J Allergy Clin Immunol. 2010;126:179–81.CrossRef
3.
go back to reference Patra S, Samal SC, Chacko A, et al. Cytomegalovirus infection of the human gastrointestinal tract. J Gastroenterol Hepatol. 1999;14:973–6.CrossRef Patra S, Samal SC, Chacko A, et al. Cytomegalovirus infection of the human gastrointestinal tract. J Gastroenterol Hepatol. 1999;14:973–6.CrossRef
4.
5.
go back to reference Bate SL, Dollard SC, Cannon MJ. Cytomegalovirus seroprevalence in the United States: the national health and nutrition examination surveys, 1988-2004. Clin Infect Dis. 2016;50:1439–47.CrossRef Bate SL, Dollard SC, Cannon MJ. Cytomegalovirus seroprevalence in the United States: the national health and nutrition examination surveys, 1988-2004. Clin Infect Dis. 2016;50:1439–47.CrossRef
6.
go back to reference Lanzieri TM, Kruszon-Moran D, Amin MM, et al. Seroprevalence of cytomegalovirus among children 1 to 5 years of age in the United States from the National Health and nutrition examination survey of 2011 to 2012. Clin Vaccine Immunol. 2015;22:245–7.CrossRef Lanzieri TM, Kruszon-Moran D, Amin MM, et al. Seroprevalence of cytomegalovirus among children 1 to 5 years of age in the United States from the National Health and nutrition examination survey of 2011 to 2012. Clin Vaccine Immunol. 2015;22:245–7.CrossRef
7.
go back to reference Goodgame RW. Gastrointestinal cytomegalovirus disease. Ann Intern Med. 1993;119:924–35.CrossRef Goodgame RW. Gastrointestinal cytomegalovirus disease. Ann Intern Med. 1993;119:924–35.CrossRef
8.
go back to reference O'Hara KM, Pontrelli G, Kunstel KL. An introduction to gastrointestinal tract CMV disease. JAAPA. 2017;30:48–52.CrossRef O'Hara KM, Pontrelli G, Kunstel KL. An introduction to gastrointestinal tract CMV disease. JAAPA. 2017;30:48–52.CrossRef
9.
go back to reference Curtis C, Ogbogu P. Hypereosinophilic syndrome. Clin Rev Allergy Immunol. 2016;50:240–51.CrossRef Curtis C, Ogbogu P. Hypereosinophilic syndrome. Clin Rev Allergy Immunol. 2016;50:240–51.CrossRef
10.
go back to reference Ogbogu PU, Bochner BS, Butterfield JH, et al. Hypereosinophilic syndrome: a multicenter, retrospective analysis of clinical characteristics and response to therapy. J Allergy Clin Immunol. 2009;124:1319–25 e3.CrossRef Ogbogu PU, Bochner BS, Butterfield JH, et al. Hypereosinophilic syndrome: a multicenter, retrospective analysis of clinical characteristics and response to therapy. J Allergy Clin Immunol. 2009;124:1319–25 e3.CrossRef
11.
go back to reference Azevedo LS, Pierrotti LC, Abdala E, et al. Cytomegalovirus infection in transplant recipients. Clinics (Sao Paulo). 2015;70:515–23.CrossRef Azevedo LS, Pierrotti LC, Abdala E, et al. Cytomegalovirus infection in transplant recipients. Clinics (Sao Paulo). 2015;70:515–23.CrossRef
12.
go back to reference Durand CM, Marr KA, Arnold CA, et al. Detection of cytomegalovirus DNA in plasma as an adjunct diagnostic for gastrointestinal tract disease in kidney and liver transplant recipients. Clin Infect Dis. 2013;57:1550–9.CrossRef Durand CM, Marr KA, Arnold CA, et al. Detection of cytomegalovirus DNA in plasma as an adjunct diagnostic for gastrointestinal tract disease in kidney and liver transplant recipients. Clin Infect Dis. 2013;57:1550–9.CrossRef
13.
go back to reference Ichikawa Y, Takeuchi M, Yamada M, et al. A case of ischemic colitis induced by hypereosinophilic syndrome. Nihon Shokakibyo Gakkai Zasshi. 2012;109(12):2074–81.PubMed Ichikawa Y, Takeuchi M, Yamada M, et al. A case of ischemic colitis induced by hypereosinophilic syndrome. Nihon Shokakibyo Gakkai Zasshi. 2012;109(12):2074–81.PubMed
14.
go back to reference Kobayashi M, Komatsu N, Kuwayama Y, et al. Idiopathic hypereosinophilic syndrome presenting acute abdomen. Intern Med. 2007;46(10):675–8.CrossRef Kobayashi M, Komatsu N, Kuwayama Y, et al. Idiopathic hypereosinophilic syndrome presenting acute abdomen. Intern Med. 2007;46(10):675–8.CrossRef
15.
go back to reference Boeckh M, Bowden RA, Goodrich JM, et al. Cytomegalovirus antigen detection in peripheral blood leukocytes after allogeneic marrow transplantation. Blood. 1992;80:1358–64.CrossRef Boeckh M, Bowden RA, Goodrich JM, et al. Cytomegalovirus antigen detection in peripheral blood leukocytes after allogeneic marrow transplantation. Blood. 1992;80:1358–64.CrossRef
16.
go back to reference Seo M, Kim DH, Gong EJ, et al. Is Follow-Up Endoscopy Necessary in Upper Gastrointestinal Cytomegalovirus Disease. Medicine (Baltimore). 2016;95:e3389.CrossRef Seo M, Kim DH, Gong EJ, et al. Is Follow-Up Endoscopy Necessary in Upper Gastrointestinal Cytomegalovirus Disease. Medicine (Baltimore). 2016;95:e3389.CrossRef
17.
go back to reference Boaretti M, Sorrentino A, Zantedeschi C, et al. Quantification of cytomegalovirus DNA by a fully automated real-time PCR for early diagnosis and monitoring of active viral infection in solid organ transplant recipients. J Clin Virol. 2013;56:124–8.CrossRef Boaretti M, Sorrentino A, Zantedeschi C, et al. Quantification of cytomegalovirus DNA by a fully automated real-time PCR for early diagnosis and monitoring of active viral infection in solid organ transplant recipients. J Clin Virol. 2013;56:124–8.CrossRef
18.
go back to reference Johnson J, Affolter K, Boynton K, et al. CMV disease in IBD: comparison of diagnostic tests and correlation with disease outcome. Inflamm Bowel Dis. 2018;24:1539–46.CrossRef Johnson J, Affolter K, Boynton K, et al. CMV disease in IBD: comparison of diagnostic tests and correlation with disease outcome. Inflamm Bowel Dis. 2018;24:1539–46.CrossRef
Metadata
Title
Colon perforation due to cytomegalovirus infection in a patient with idiopathic hypereosinophilic syndrome: a case report
Authors
Bin Luo
Chengxin Deng
Tieying Hou
Fangping Xu
Qianchao Liao
Yong Li
Junjiang Wang
Publication date
01-12-2020
Publisher
BioMed Central
Published in
BMC Gastroenterology / Issue 1/2020
Electronic ISSN: 1471-230X
DOI
https://doi.org/10.1186/s12876-020-01381-1

Other articles of this Issue 1/2020

BMC Gastroenterology 1/2020 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine