CMV in the gut: a critical review of CMV detection in the immunocompetent host with colitis

Goodman, Anna; Murray, Charles; Watkins, J. R.; Griffiths, Paul; Webster, Daniel P.

doi:10.1007/s10096-014-2212-x

Cited by 51 publications

(42 citation statements)

References 22 publications

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“…The secondary infection was treated with ganciclovir and vancomycin. Retrospective studies have shown that the effective median course of treatment with ganciclovir is 14 days. For patients with immunodeficiency combined with CMV enteritis, the course of treatment is for 3–6 weeks, or until symptoms disappear.…”

Section: Discussionmentioning

confidence: 99%

Opportunistic bowel infection after corticosteroid dosage tapering in a stage IV lung cancer patient with tislelizumab‐related colitis

Zhang

2020

Thoracic Cancer

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Immune checkpoint inhibitors, the new standard in cancer therapy, present durable responses in numerous solid tumors and hematologic malignancies, as well as resulting in an increased incidence of immune-related adverse events (irAEs). Diarrhea is a common irAE, with an incidence rate of approximately 10% to 13%. It is important to distinguish between diarrhea symptomatic of an infection, which is the main differential diagnosis, and immune-related diarrhea. Here, we report a case of an advanced lung cancer patient who presented with diarrhea as a result of treatment with tislelizumab, a novel PD-1 inhibitor. Although the patient initially responded to corticosteroid treatment, diarrhea recurred upon dosage tapering, and eventually improved on treatment with ganciclovir and vancomycin. Therefore, clinicians must remain highly vigilant against infection and carefully distinguish symptoms of infection from irAEs by performing repeated blood or fecal examinations for pathogens, colonoscopy, and biopsy.

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Section: Discussionmentioning

confidence: 99%

Opportunistic bowel infection after corticosteroid dosage tapering in a stage IV lung cancer patient with tislelizumab‐related colitis

Zhang

2020

Thoracic Cancer

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“…Although CMV colitis has also been reported in immunocompetent patients, including those admitted to the intensive care unit for a variety of reasons, [7][8][9][10][11] it is more commonly associated with immune suppression. Patients with IBD and solid organ transplant recipients are particularly susceptible.…”

Section: Discussionmentioning

confidence: 99%

The Significance of So-Called Equivocal Immunohistochemical Staining for Cytomegalovirus in Colorectal Biopsies

Ambelil

Saulino

Ertan

et al. 2019

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Recent studies examining immunohistochemical staining of colorectal biopsies for cytomegalovirus (CMV) reported that some cases showed only occasional small positive nuclei that were called equivocal for CMV. Objectives.— To determine the extent and clinical significance of equivocal CMV staining in colorectal biopsies. Design.— Two-hundred twenty-one consecutive cases of colon and rectal biopsies that were stained for CMV by immunohistochemistry were retrieved from our files and reviewed. Staining results were recorded as negative, unequivocal, or equivocal. Results were correlated with clinicopathologic data, results of polymerase chain reaction studies for CMV, and treatment history. Results.— Fifty-two cases (24% of all tested, 63% of positive cases) showed equivocal staining for CMV, and of these, 41 had follow-up information. Polymerase chain reaction for CMV was performed largely on blood samples and was not found to be sensitive for the detections of CMV proctocolitis. Of 25 patients who received antiviral treatment, 21 (84%) had complete resolution of symptoms, compared with 8 of 16 (50%) who did not receive antivirals (P = .02). There was no statistically significant difference in response to antiviral drugs in patients with equivocal and unequivocal CMV staining (P = .17). Conclusions.— Equivocal CMV staining likely represents true CMV proctocolitis. Prospective studies are needed to confirm these findings.

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“…No hay estudios controlados que guíen el tratamiento (9). Se plantea que en los pacientes menores de 50 años y sin comorbilidades podría diferirse el uso de antivirales, pues hay una chance de resolución espontánea entre el 24 al 51 % (10); sin embargo, en general se utiliza ganciclovir intravenoso por un periodo de 14 a 21 días de tratamiento, sobre todo en los casos más graves.…”

Section: Discussionunclassified

Colitis por citomegalovirus en paciente inmunocompetente

Ramírez-Quintero

2018

iatreia

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RESUMENLa infección grave por citomegalovirus en pacientes inmunocompetentes es inusual, siendo la colitis su principal manifestación. Se observa predominantemente en pacientes ancianos con alta carga de comorbilidades. Presentamos el caso de una mujer con falla cardiaca de origen isquémico agudamente descompensada, quien presentó hemorragia digestiva inferior secundaria a colitis por citomegalovirus en ausencia de inmunosupresión aparente. PALABRAS CLAVEColitis; Hemorragia Gastrointestinal; Infecciones por Citomegalovirus; Inmunocompetencia; Isquemia Miocárdica SUMMARY Cytomegalovirus colitis in an immunocompetent patientSevere cytomegalovirus infection in immunocompetent patients is unusual with colitis being its main manifestation. It occurs predominantly in elderly patients with high burden of comorbidities. A case of a woman with acute heart failure and coronary heart disease who had lower gastrointestinal bleeding due to cytomegalovirus colitis in the absence of apparent immunosuppression is presented.

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CMV in the gut: a critical review of CMV detection in the immunocompetent host with colitis

Cited by 51 publications

References 22 publications

Opportunistic bowel infection after corticosteroid dosage tapering in a stage IV lung cancer patient with tislelizumab‐related colitis

Opportunistic bowel infection after corticosteroid dosage tapering in a stage IV lung cancer patient with tislelizumab‐related colitis

The Significance of So-Called Equivocal Immunohistochemical Staining for Cytomegalovirus in Colorectal Biopsies

Colitis por citomegalovirus en paciente inmunocompetente

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