Br. Feliu et al., CYTOMEGALOVIRUS ENTERITIS AND COLITIS IN NONIMMUNOCOMPROMISED PATIENTS - PRIMARY DISORDER OR SUPERINFECTION, Revista espanola de enfermedades digestivas, 86(4), 1994, pp. 727-731
Cytomegalovirus disease is an opportunistic infection that is seen in
patients with immunodeficiencies. The group most commonly affected are
AIDS and transplanted patients. Only a few cases of cytomegalovirus d
isease in non-immunocompromised patients have been reported. In locali
zed disease, the gastrointestinal tract is the most frequently affecte
d. We report two cases of acute abdomen caused by cytomegalovirus ente
ritis and colitis (histophatological diagnosis) without any underlying
immune disorder. The role that the cytomegalovirus infection might pl
ay in the development of the clinical manifestations in these two case
s is discussed. Without an established immunodeficiency we must be car
eful to attribute to cytomegalovirus infection the direct responsabili
ty of the lesions. In the reported cases, the existence of intestinal
ischemia is more than just a clinical hypothesis and pathological exam
ination is inconclusive. The absence of an immunocompromised state, th
e presentation as an acute abdomen and the clinical course forwards in
testinal occlusion in the first case are not characteristic of cytomeg
alovirus enteritis and colitis. We conclude that the two reported case
s are in fact an ischemic enteritis upon which cytomegalovirus enterit
is and colitis was superimposed, an association that has not been repo
rted before.