Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2016 Aug 21;22(31):7166-74.
doi: 10.3748/wjg.v22.i31.7166.

Cytomegalovirus related fatal duodenal diverticular bleeding: Case report and literature review

Jasbir Makker  1 , Bharat Bajantri  1 , Sailaja Sakam  1 , Sridhar Chilimuri  1
Affiliations
Review

Cytomegalovirus related fatal duodenal diverticular bleeding: Case report and literature review

Jasbir Makker et al. World J Gastroenterol. .

Abstract

Involvement of gastrointestinal tract by cytomegalovirus (CMV) is common. CMV infections mainly run their course without any clinical signs in immunocompetent hosts. In contrast, CMV can cause severe infections with serious consequences in a immunocompromised state typically associated with organ transplants, highly immunosuppressive cancer chemotherapy, advanced HIV infection or treatment with corticosteroids. The incidence and severity of these manifestations of CMV is directly proportional with the degree of cellular immune dysfunction, i.e., CD8+ Cytotoxic T-cell response. Clinical manifestations of CMV can become apparent in different situations including reactivation of CMV from latency, primary infection in a seronegative host, or exposure of a seropositive host to a new strain of CMV. As the clinical signs of CMV in immunodeficient patients are usually sparse, physicians should be highly vigilant about CMV infection, a treatable condition that otherwise is associated with significant mortality. Here we report a rare case of severe gastrointestinal CMV infection with sustained immunodeficiency secondary to treatment with steroids manifesting as fatal duodenal diverticular bleeding.

Keywords: Cytomegalovirus; Duodenal bleed; Duodenal hemorrhage; Gastrointestinal.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Post mortem examination showed large well-circumscribed duodenal diverticulum with ulcerated mucosa adjacent to eroded artery in posterior wall of first part of duodenum. A: Artery adjacent to the ulcerated mucosa in duodenal diverticulum; B: Duodenal mucosa - Artery adjacent to the ulcerated mucosa in duodenal diverticulum (Hematoxylin and eosin × 200).
Figure 2
Figure 2
Owl’s eye inclusion body in duodenal diverticulum.
Figure 3
Figure 3
Cytomegalovirus structure.
Figure 4
Figure 4
Approach to mononucleosis. CMV: Cytomegalovirus.
Figure 5
Figure 5
Manifestations of cytomegalovirus.
Figure 6
Figure 6
Cytomegalovirus gastrointestinal manifestations.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

References

    1. Rafailidis PI, Mourtzoukou EG, Varbobitis IC, Falagas ME. Severe cytomegalovirus infection in apparently immunocompetent patients: a systematic review. Virol J. 2008;5:47. - PMC - PubMed
    1. Ho M. The history of cytomegalovirus and its diseases. Med Microbiol Immunol. 2008;197:65–73. - PubMed
    1. Vonglahn WC, Pappenheimer AM. Intranuclear Inclusions in Visceral Disease. Am J Pathol. 1925;1:445–466.3. - PMC - PubMed
    1. Ma Y, Wang N, Li M, Gao S, Wang L, Zheng B, Qi Y, Ruan Q. Human CMV transcripts: an overview. Future Microbiol. 2012;7:577–593. - PubMed
    1. Vanarsdall AL, Johnson DC. Human cytomegalovirus entry into cells. Curr Opin Virol. 2012;2:37–42. - PMC - PubMed