Recurrent cytomegalovirus colitis: a rare case of immune reconstitution inflammatory syndrome

Joseph Alukal, Mohammed Asif, Rachana Mundada, William B. McNamee

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

Cytomegalovirus (CMV) colitis usually occurs in patients with advanced immunosuppression when the CD4 count is <50 cells/μL. We reported a case of recurrent CMV colitis in a patient with HIV who presented with profuse lower gastrointestinal bleed. This was a case of immune reconstitution inflammatory syndrome (IRIS) manifesting as CMV colitis and has been reported only once in the literature previously. This patient had a CD4 count of 157 cells/μL and undetectable viral load after being on antiretroviral therapy (ART) for 5 months, which was consistent with IRIS. The diagnosis of CMV was confirmed by a colonoscopy and a biopsy. This case highlights the fact that CMV colitis can manifest despite a moderately preserved CD4 count and the clinicians must have a high index suspicion for IRIS syndrome especially when someone was recently started on ART. Since effective treatment is available, it is important not to miss the diagnosis of CMV colitis.

Original languageEnglish (US)
JournalBMJ case reports
Volume2018
DOIs
StatePublished - Jan 4 2018
Externally publishedYes

Keywords

  • Hiv / Aids
  • endoscopy
  • gastroenterology
  • infection (gastroenterology)
  • ulcer

ASJC Scopus subject areas

  • General Medicine

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