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572 Intractable Diarrhea from Cytomegalovirus Colitis in an Immunocompetent Adolescent
  1. O Canan1,
  2. S Asilsoy2,
  3. N Bal3,
  4. M Özkale4,
  5. A Noyan5,
  6. F Ozcay1
  1. 1Pediatric Gastroenterology
  2. 2Pediatric Allergy
  3. 3Pathology
  4. 4Pediatric
  5. 5Pediatric Nephrology, Baskent University, Adana, Turkey

Abstract

Introduction We reported CMV colitis in an immunocompetent adolescent who was critically ill with septicaemia and significant intractable diarrhea that responded to specific CMV treatment.

Case A 15-year-old boy who previously known hereditary spherocytosis was referred to our hospital because of anemia, increased transaminase level, and massive cholestasis. The abdominal ultrasonography was detected cholelithiasis, choledoch stones, and dilated proximally bile ducts. External biliary drainage tube was placed into the choledoch. On the following days, spleenic rupture and sepsis developed. Therefore, the patient was underwent splenectomy and cholecystectomy. After closed of external biliary drainage tube, patient was developed severe dehydration and malnutrition due to watery stool. The colonoscopy and colonic biopsies was performed. It was shown macroscopic colitis and CMV intranuclear inclusion bodies in rectosigmoid colon. Morever, PCR for CMV DNA in blood (6142 copy/mL) and colonic biopsy speciments was positive. The immunologic screen tests were normal. Parenteral gancyclovir for 21 days and oral gancyclovir therapy was continued two weeks. The patient resolved completely, serum PCR for CMV DNA was detected negative after two months.

Conclusion CMV colitis, although rare in immunocompetent adolescent, should be considered in the differential diagnosis of severe colitis when other causes fail to explain the course of disease.

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