Clinicopathological Profile of CMV Colitis at a Tertiary Care Center

Abstract

Introduction: Cytomegalovirus (CMV) infection is commonly seen in immunosuppressed individuals like Acquired Immunodeficiency Syndrome (AIDS), receiving chemotherapy/other immunosuppressive drugs, Inflammatory Bowel Disease (IBD). Rarely seen in immunocompetent individuals; CMV can involve any part of gastrointestinal tract, but commonly involves the colon. Aim: To study the clinicopathological features of CMV colitis at St John’s Medical College. Materials and Methods: A retrospective study involving all CMV colitis patients admitted in the hospital from January 2010 to December 2017 was conducted. All histopathologically proven cases of CMV colitis were included. From the hospital records clinical, demographic and serological data were retrieved. Histopathology slides were reviewed. Results: Eighteen patients with CMV colitis were studied. Mean age was 57 years (range 32-86). The underlying predisposing factors like AIDS, post organ transplant, IBD were seen in 10 patients. Eight patients were immunocompetent. CMV DNA data was available in eight patients. The common clinical presentation was chronic diarrhoea, bleed PR, acute exacerbation of ulcerative colitis. All patients histopathology revealed characteristic inclusion bodies except in two, which were confirmed by IHC. Conclusion: CMV colitis is commonly seen in immunosuppressed individual but can also be seen in immunocompetent. High index of suspicion in immunosuppressed individual with typical clinical symptoms is important for early diagnosis and treatment.

Keywords

• gastrointestinal tract
• immunosuppression
• viral inclusions