Korean J Med.  2002 Dec;63(6):720-724.

Cytomegalovirus colitis causing toxic megacolon in a patient with focal segmental glomerulosclerosis

Affiliations
  • 1Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea. yousunk69@korea.com

Abstract

Cytomegalovirus is a frequent opportunistic pathogen in immunosuppressed patients and CMV colitis is one of its major complications. It usually presents as gastrointestinal ulceration with bleeding or perforation, but it can also take less common forms resembling many other entities, including viral gastroenteritis, ischemic colitis, intestinal pseudo-obstuction, toxic megacolon. We experienced a 49-year-old man with symptom of severe constipation and lower abdominal pain. He was diagnosed as having focal segmental glomerulosclerosis by renal biopsy, but he was an immunocompetent state. An abdominal X-ray showed marked dilatation of descending colon without air-fluid level. At colonoscopy and biopsy, he was diagnosed as having CMV colitis with focal stenosis. Treatment for two weeks with ganciclovir resulted in resolution of colitis, but stenosis was remained. We report a case of toxic megacolon and focal stenosis due to CMV colitis in a FSGS patient. It was not certain whether FSGS was related with immunosuppressive state.

Keyword

Megacolon; Colitis; Cytomegalovirus; Glomerulosclerosis; Focal

MeSH Terms

Abdominal Pain
Biopsy
Colitis*
Colitis, Ischemic
Colon, Descending
Colonoscopy
Constipation
Constriction, Pathologic
Cytomegalovirus*
Dilatation
Ganciclovir
Gastroenteritis
Glomerulosclerosis, Focal Segmental*
Hemorrhage
Humans
Megacolon
Megacolon, Toxic*
Middle Aged
Ulcer
Ganciclovir
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