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Case Reports
. 2023 Feb 25;15(2):e35473.
doi: 10.7759/cureus.35473. eCollection 2023 Feb.

Cytomegalovirus Colitis in a Patient With Ulcerative Colitis on Vedolizumab Monotherapy

Yaser Meeralam  1 , Bushra Al Qurashi  2 , Assel Al Masoudi  2 , Talal L Alhejaili  1 , Mohammed Khayat  1 , Anas M Aljoaid  1 , Wallaa Al Harthi  1 , Waleed A Hafiz  3 , Mohammed K Shariff  1
Affiliations
Case Reports

Cytomegalovirus Colitis in a Patient With Ulcerative Colitis on Vedolizumab Monotherapy

Yaser Meeralam et al. Cureus. .

Abstract

Cytomegalovirus (CMV) is a human herpes-type virus with variable clinical manifestations. Infections in immunocompetent patients are usually asymptomatic or mild, and severe infections are generally seen in immunosuppressed individuals. CMV colitis is not uncommon in patients with ulcerative colitis (UC) and is mostly associated with the use of steroids, immunomodulators like azathioprine, and biologics like infliximab, which have systemic immunosuppressive effects. Vedolizumab is an anti-integrin antibody that is gut-selective without any systemic effects. We report an unusual presentation of a female patient with UC who had concomitant CMV colitis and erythema nodosum, who was on vedolizumab, and not on any steroids or other immunosuppressants. She responded well to anti-viral treatment and steroids.

Keywords: cmv; extra-intestinal manifestation; inflammatory bowel disease; ulcerative colitis; vedolizumab.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Severe colonic inflammation with whitish exudate
Figure 2
Figure 2. Ulcerated colonic tissue with marked chronic active colitis, cryptitis, and regenerative epithelium
See this image and copyright information in PMC

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