[Fatal toxic megacolon due to cytomegalovirosis in a patient with ulcerative colitis: case report and review].

BACKGROUND

The toxic megacolon is a rare and severe complication of ulcerative colitis. In general it complicates patients with active colitis that are resistant to clinical treatment and, in some cases, the developing factor is unknown. Cytomegalovirus infection in humans in general is a subclinical condition. However, in patients with immunodeficiency the primary infection or the reactivation of latent infection could have enormous clinical effects. One of these effects is the toxic megacolon.

AIM: To report a case of fatal toxic megac lon due to cytomegalovirosis in a patient with ulcerative colitis.

PATIENT: A male patient, 38 years old, with complaints of diarrhea and weight loss. The diagnosis of ulcerative colitis was made and a vigorous immunossupressive therapy was performed.

RESULTS

Due to the evolution to a toxic megacolon the patient was submitted to colectomy. In the post-operatory period there were severe clinical complications and the patient died. The pathological study of the colon revealed active ulcerative colitis, associated with confluent ulcerations and numerous cells with cytomegalic nuclear inclusions.

CONCLUSION

The cytomegalovirosis must be considered as one of the causal agent of toxic megacolon in ulcerative colitis.