[Cytomegalovirus colitis in an elderly polytraumatised patient].

HISTORY AND CLINICAL FINDINGS: During a long-term stay on a intensive-care unit a polytraumatised elderly patient developed hematochezia, which was refractory to blood transfusion.

INVESTIGATIONS AND DIAGNOSIS: During colonoscopy, multiple ulcers were found in the right colon and rectum, and right hemicolectomy was performed after another massive anal blood loss. Histological findings showed characteristic intranuclear inclusions, positive Cytomegalovirus (CMV)-IgM titer and positive polymerase chain reaction (PCR) in blood.

TREATMENT AND COURSE: After hemicolectomy, antiviral therapy with ganciclovir was initiated for two weeks intravenously, and no more gastrointestinal symptoms occurred. In the following days, enteral alimentation was continued without problems.

CONCLUSIONS

CMV colitis should be considered in immunoincompetent patients after more common etiologies for severe diarrhea have been excluded. Timely diagnosis is essential to improve the outcome for elderly patients or patients with severe co-morbidities.