Ruxolitinib and vedolizumab salvage therapy in the setting of cytomegalovirus colitis for a patient with newly diagnosed very early onset inflammatory bowel disease.

Acute severe ulcerative colitis increases the risk for cytomegalovirus (CMV) infection, particularly with the use of immunocompromising medications. We report a case of a 4-year-old with newly diagnosed very early onset inflammatory bowel disease presenting with acute severe colitis refractory to both corticosteroids and infliximab, whose course was complicated by CMV colitis. Clinical remission was achieved with combination salvage therapy of ruxolitinib and vedolizumab. Clearance of CMV was not impaired with this regimen. Initiating combination Janus Kinase inhibition and anti-integrin salvage therapy in the setting of CMV infection and acute severe colitis is not previously described.