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 Presentation
- Fever
- Anorexia
- Malaise
- Weight loss
- Dehydration
- Abdominal pain
- Abdominal distention
- Nausea
- Vomiting
- Chronic watery diarrhea
- Bloody diarrhea
- Constipation
- Worsening symptoms of inflammatory bowel disease
Differential Diagnosis
- Bacterial Gastroenteritis
- Campylobacter Infections
- Clostridium Difficile Colitis
- Colon Cancer
- Crohn Disease
- Cryptosporidiosis
- Mycobacterium Avium-Intracellulare
- Toxic Megacolon
- Ulcerative Colitis
- Viral Gastroenteritis
Diagnosis
Management
Disposition
- 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)