CMV colitis

Background

• CMV is part of the Herpesviridae family
• 50-80% of the world's population is seropositive for CMV
• Causes a mild or undetectable infection in immunocompetent hosts
• Severe systemic illness is found in immunosuppressed hosts

Clinical Features

• Fever
• Anorexia
• Malaise
• Abdominal pain, Abdominal distention, constipation
• Nausea/vomiting
• Chronic watery diarrhea
• Bloody diarrhea
• Worsening symptoms of inflammatory bowel disease
• Weight loss
• Dehydration

Differential Diagnosis

Colitis

• Viral gastroenteritis
• Bacterial gastroenteritis
• Campylobacter infections
• Clostridium difficile colitis
• Colon cancer
• Crohn disease
• Cryptosporidiosis
• Mycobacterium Avium-Intracellulare
• Toxic megacolon
• Ulcerative colitis
• Ischemic bowel disease (e.g. mesenteric ischemia, strangulated hernia)
• Pseudomembranous enterocolitis
• Lymphoma
• Ileocecal amebiasis
• Sarcoidosis
• Yersinia
• Campylobacter

CMV Diseases

• CMV esophagitis
• CMV colitis
• CMV pneumonia
• CMV retinitis
• CMV neurologic disease

Management

• Ganciclovir 5mg/kg IV q12hrs x 21 days (or until resolution of symptoms)
• Foscarnet 90mg/kg IV q12hrs daily x 21 days (or until resolution of symptoms)

See Also

• Cytomegalovirus (CMV) infection