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)

See Also

External Links

References