[Cytomegalovirus enteritis and colitis in nonimmunodepressed patients, a primary disease or superinfection?]

Abstract

Cytomegalovirus disease is an opportunistic infection that is seen in patients with inmunodeficiencies. The group most commonly affected are AIDS and transplanted patients. Only a few cases of cytomegalovirus disease in non-immunocompromised patients have been reported. In localized disease, the gastrointestinal tract is the most frequently affected. We report two cases of acute abdomen caused by cytomegalovirus enteritis and colitis (histopathological diagnosis) without any underlying immune disorder. The role that the cytomegalovirus infection might play in the development of the clinical manifestations in these two cases is discussed. Without an established immunodeficiency we must be careful to attribute to cytomegalovirus infection the direct responsibility of the lesions. In the reported cases, the existence of intestinal ischemia is more than just a clinical hypothesis and pathological examination is inconclusive. The absence of an immunocompromised state, the presentation as an acute abdomen and the clinical course forwards intestinal occlusion in the first case are not characteristic of cytomegalovirus enteritis and colitis. We conclude that the two reported cases are in fact an ischemic enteritis upon which cytomegalovirus enteritis and colitis was superimposed, an association that has not been reported before.