Acute Cytomegalovirus Infection Superimposed on Corticosteroid-Naïve Ulcerative Colitis

Rie Osaki; Akira Andoh; Tomoyuki Tsujikawa; Atsuhiro Ogawa; Yuhsuke Koizumi; Tamio Nakahara; Kazunori Hata; Masaya Sasaki; Yasuharu Saito; Yoshihide Fujiyama

doi:10.2169/internalmedicine.47.1039

CASE REPORTS

Acute Cytomegalovirus Infection Superimposed on Corticosteroid-Naïve Ulcerative Colitis

Rie Osaki, Akira Andoh, Tomoyuki Tsujikawa, Atsuhiro Ogawa, Yuhsuke Koizumi, Tamio Nakahara, Kazunori Hata, Masaya Sasaki, Yasuharu Saito, Yoshihide Fujiyama

Author information

Rie Osaki
Department of Medicine, Shiga University of Medical Science
Akira Andoh
Department of Medicine, Shiga University of Medical Science
Tomoyuki Tsujikawa
Department of Medicine, Shiga University of Medical Science
Atsuhiro Ogawa
Department of Medicine, Shiga University of Medical Science
Yuhsuke Koizumi
Department of Medicine, Shiga University of Medical Science
Tamio Nakahara
Department of Medicine, Shiga University of Medical Science
Kazunori Hata
Department of Medicine, Shiga University of Medical Science
Masaya Sasaki
Department of Medicine, Shiga University of Medical Science
Yasuharu Saito
Department of Endoscopy, Shiga University of Medical Science
Yoshihide Fujiyama
Department of Medicine, Shiga University of Medical Science

Keywords: IBD, cytomegalovirus, superimpose

JOURNAL OPEN ACCESS

2008 Volume 47 Issue 14 Pages 1341-1344

DOI https://doi.org/10.2169/internalmedicine.47.1039

Details

Abstract

Most cases of cytomegalovirus (CMV) colitis that develop in patients with inflammatory bowel disease (IBD) are caused by a reactivation of a latent virus; acute CMV infections are rare. Treatment with immunosuppressive agents further increases the infection risk. Here, we present a 32-year-old man with acute CMV-mononucleosis and colitis, superimposed on corticosteroid-naïve ulcerative colitis (UC). The diagnosis was confirmed by a viral-like prodrome, positive CMV antigenemia (C7-HRP), a positive CMV IgM titer, the presence of atypical lymphocytes, mild transaminase elevation, and immunohistological detection of CMV positive cells in his colonic mucosa. Gancyclovir was intravenously administered, and all symptoms were improved.

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