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
. 2021 Mar 18;11(1):6284.
doi: 10.1038/s41598-021-85845-8.

Endoscopic features and clinical outcomes of cytomegalovirus gastroenterocolitis in immunocompetent patients

Jiyoung Yoon #  1 , Junghwan Lee #  1 , Dae Sung Kim  1 , Jin Wook Lee  1 , Seung Wook Hong  1 , Ha Won Hwang  1 , Sung Wook Hwang  1 , Sang Hyoung Park  1 , Dong-Hoon Yang  1 , Byong Duk Ye  1 , Seung-Jae Myung  1 , Hwoon-Yong Jung  1 , Suk-Kyun Yang  1 , Jeong-Sik Byeon  2
Affiliations

Endoscopic features and clinical outcomes of cytomegalovirus gastroenterocolitis in immunocompetent patients

Jiyoung Yoon et al. Sci Rep. .

Abstract

We aimed to investigate the endoscopic features and clinical course of CMV gastroenterocolitis in immunocompetent patients. We reviewed the medical records and endoscopic images of 86 immunocompetent patients with CMV gastroenterocolitis. Immunocompetent patients were defined as those without congenital or acquired immunodeficiency syndrome, use of anti-cancer chemotherapeutic and immunosuppressive agents, and inflammatory bowel diseases. The mean age was 65.5 ± 11.8 years and 53 (61.6%) were male. Sixty-eight (79.1%) patients had comorbidities. Upper gastrointestinal-dominant, small bowel-dominant, and colon-dominant types were observed in 19, 7, and 60 patients, respectively. Endoscopic features could be classified into discrete ulcerative type with/without exudate and diffuse erythematous type with/without exudate. Antiviral treatment with ganciclovir was initiated in 51 patients (59.3%), 40 of whom improved and 1 improved after changing ganciclovir to foscarnet. Thirty-three patients (38.4%) improved without antiviral treatment. Surgery was necessary in two patients because of colon perforation before antiviral treatment. Another two patients underwent surgery because of sigmoid stricture and cecal perforation during antiviral treatment. Endoscopic type was not associated with clinical outcomes, such as surgery and death. CMV gastroenterocolitis in immunocompetent patients mostly occur in older patients with comorbidities, and the endoscopic features vary with no association with clinical outcomes.

PubMed Disclaimer

Conflict of interest statement

The authors declare no competing interests.

Figures

Figure 1
Figure 1
Age at the diagnosis of cytomegalovirus gastroenterocolitis in immunocompetent patients.
Figure 2
Figure 2
Endoscopic types according to gross features. (A) Discrete ulcerative type with exudate. (B) Discrete ulcerative type without exudate. (C) Diffuse erythematous type with exudate. (D) Diffuse erythematous type without exudate. All images (A–D) are cytomegalovirus colitis.
Figure 3
Figure 3
Proportions of endoscopic types according to sites of cytomegalovirus involvement. UGI, upper gastrointestinal tract; SB, small bowel.
Figure 4
Figure 4
Clinical course of cytomegalovirus gastroenterocolitis in immunocompetent patients according to (A) location of involvement. (B) endoscopic type. UGI, upper gastrointestinal; SB, small bowel; DM, diabetes mellitus; ESRD, end-stage renal disease; CKD, chronic kidney disease; AAA, abdominal aortic aneurysm; LC, liver cirrhosis; VT, ventricular tachycardia; CHF, congestive heart failure. *Death cases are presented as sex/age, comorbidities, and cause of death.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Lachance P, Chen J, Featherstone R, Sligl WI. Association between cytomegalovirus reactivation and clinical outcomes in immunocompetent critically ill patients: A systematic review and meta-analysis. Open Forum Infect. Dis. 2017;4:ofx029. doi: 10.1093/ofid/ofx029. - DOI - PMC - PubMed
    1. You DM, Johnson MD. Cytomegalovirus infection and the gastrointestinal tract. Curr. Gastroenterol. Rep. 2012;14:334–342. doi: 10.1007/s11894-012-0266-4. - DOI - PubMed
    1. Galiatsatos P, Shrier I, Lamoureux E, Szilagyi A. Meta-analysis of outcome of cytomegalovirus colitis in immunocompetent hosts. Dig. Dis. Sci. 2005;50:609–616. doi: 10.1007/s10620-005-2544-6. - DOI - PubMed
    1. Iwamuro M, et al. Endoscopic manifestations and clinical characteristics of cytomegalovirus infection in the upper gastrointestinal tract. Acta Med Okayama. 2017;71:97–104. doi: 10.18926/amo/54977. - DOI - PubMed
    1. Grilli E, Galati V, Bordi L, Taglietti F, Petrosillo N. Cytomegalovirus pneumonia in immunocompetent host: Case report and literature review. J. Clin. Virol. 2012;55:356–359. doi: 10.1016/j.jcv.2012.08.010. - DOI - PubMed

MeSH terms