PMID- 29301795
OWN - NLM
STAT- MEDLINE
DCOM- 20180803
LR  - 20200105
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 2018
DP  - 2018 Jan 4
TI  - Recurrent cytomegalovirus colitis: a rare case of immune reconstitution 
      inflammatory syndrome.
LID - bcr-2017-221121 [pii]
LID - 10.1136/bcr-2017-221121 [doi]
LID - bcr2017221121
AB  - Cytomegalovirus (CMV) colitis usually occurs in patients with advanced 
      immunosuppression when the CD4 count is <50 cells/muL. 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/muL 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.
CI  - (c) BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 
      2018. All rights reserved. No commercial use is permitted unless otherwise 
      expressly granted.
FAU - Alukal, Joseph
AU  - Alukal J
AD  - Department of Internal Medicine, Mercy Fitzgerald Hospital, Darby, Pennsylvania, 
      USA.
FAU - Asif, Mohammed
AU  - Asif M
AD  - Department of Surgery, Mercy Fitzgerald Hospital, Darby, Pennsylvania, USA.
FAU - Mundada, Rachana
AU  - Mundada R
AD  - Department of Internal Medicine, Mercy Fitzgerald Hospital, Darby, Pennsylvania, 
      USA.
FAU - McNamee, William B
AU  - McNamee WB
AD  - Department of Internal Medicine-Infectious Disease, Mercy Fitzgerald Hospital, 
      Darby, Pennsylvania, USA.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20180104
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
SB  - IM
MH  - Colitis/*virology
MH  - Cytomegalovirus
MH  - Cytomegalovirus Infections/*complications/virology
MH  - Female
MH  - Gastrointestinal Hemorrhage/*virology
MH  - HIV Infections/*complications/virology
MH  - Humans
MH  - Immune Reconstitution Inflammatory Syndrome/*complications/virology
MH  - Middle Aged
MH  - Recurrence
PMC - PMC5787009
OTO - NOTNLM
OT  - Hiv / Aids
OT  - endoscopy
OT  - gastroenterology
OT  - infection (gastroenterology)
OT  - ulcer
COIS- Competing interests: None declared.
EDAT- 2018/01/06 06:00
MHDA- 2018/08/04 06:00
PMCR- 2020/01/04
CRDT- 2018/01/06 06:00
PHST- 2018/01/06 06:00 [entrez]
PHST- 2018/01/06 06:00 [pubmed]
PHST- 2018/08/04 06:00 [medline]
PHST- 2020/01/04 00:00 [pmc-release]
AID - bcr-2017-221121 [pii]
AID - 10.1136/bcr-2017-221121 [doi]
PST - epublish
SO  - BMJ Case Rep. 2018 Jan 4;2018:bcr2017221121. doi: 10.1136/bcr-2017-221121.