A CASE OF TOXIC MEGACOLON IN ULCERATIVE-COLITIS ASSOCIATED WITH CYTOMEGALOVIRUS-INFECTION

Cytomegalovirus (CMV) infection, which has been shown to complicate th e course of ulcerative colitis (UC), has been implicated as a possible etiologic factor in the exacerbation of UC, especially in toxic megac olon. However, CMV infection in patients with UC accompanied by toxic megacolon has rarely been reported. Here we report a case of CMV infec tion of the colon accompanied by toxic megacolon occurring in UC. A 38 -year-old woman had been treated with intravenous hydrocortisone, rect al steroid, and central venous alimentation for 6 weeks under the diag nosis of UC. She was transferred to Akita University Hospital because of increasing bloody diarrhea and abdominal pain. Toxic megacolon was identified by examinations on admission, and she underwent a total col ectomy. Examination of the surgical specimen showed severe inflammatio n of the colon. Microscopically, cytomegalic inclusions were observed in and around the endothelial cells in the inflamed submucosal layer. It can be assumed that CMV infection was a secondary, opportunistic in vader superimposed on UC, and that it played an important role in alte ring the clinical course of the patient.