Yang QH, Ma XP, Dai DL, Bai DM, Zou Y, Liu SX, Song JM. Gastrointestinal cytomegalovirus disease secondary to measles in an immunocompetent infant: A case report. World J Gastroenterol 2021; 27(15): 1655-1663 [PMID: 33958850 DOI: 10.3748/wjg.v27.i15.1655]
Corresponding Author of This Article
Dong-Ling Dai, MD, PhD, Chief Doctor, Professor, Endoscopy Center and Gastroenterology Department, Shenzhen Children's Hospital, No. 7019 Yitian Road, Futian District, Shenzhen 518036, Guangdong Province, China. daidong3529@sina.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Qing-Hua Yang, Xiao-Peng Ma, Dong-Ling Dai, Da-Ming Bai, Yu Zou, Si-Xi Liu, Endoscopy Center and Gastroenterology Department, Shenzhen Children's Hospital, Shenzhen 518036, Guangdong Province, China
Jian-Ming Song, Department of Pathology, Shenzhen Children's Hospital, Shenzhen 518036, Guangdong Province, China
Author contributions: Yang QH drafted the manuscript and analyzed the data; Liu SX, Bai DM, and Zou Y were involved in patient management and follow-up; Dai DL and Ma XP designed and supervised the study; Song JM contributed to data acquisition, analysis, and interpretation; Dai DL and Ma XP contributed equally to this manuscript; all of the authors approved the submission of this manuscript.
Supported byShenzhen Innovation and Technology Committee, No. JCYJ20180228175150018.
Informed consent statement: Consent was obtained from the parents of the patient for publication of the case report and any accompanying images.
Conflict-of-interest statement: The authors who took part in this study declare that they do not have anything to disclose regarding funding or a conflict of interest with respect to this manuscript.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong-Ling Dai, MD, PhD, Chief Doctor, Professor, Endoscopy Center and Gastroenterology Department, Shenzhen Children's Hospital, No. 7019 Yitian Road, Futian District, Shenzhen 518036, Guangdong Province, China. daidong3529@sina.com
Received: January 14, 2021 Peer-review started: January 14, 2021 First decision: February 10, 2021 Revised: February 19, 2021 Accepted: March 25, 2021 Article in press: March 25, 2021 Published online: April 21, 2021 Processing time: 89 Days and 23.5 Hours
Abstract
BACKGROUND
Gastrointestinal cytomegalovirus (CMV) disease occurs commonly in immunocompromised/immunodeficient patients with advanced human immunodeficiency virus infection, neoplasm, solid organ transplantation, hematopoietic stem cell transplantation, or treatment with immunosuppressants, but is rarely reported in association with measles infection.
CASE SUMMARY
We describe a case of extensive gastrointestinal CMV disease secondary to measles infection in a 9-mo-old boy who presented with persistent fever and bloody diarrhea. His condition was improved after ganciclovir treatment. Serological analysis of CMV showed negative immunoglobulin (Ig) M and positive IgG. Blood CMV-DNA was 9.26 × 103 copies/mL. The diagnosis of gastrointestinal CMV disease was confirmed by histopathological findings of intranuclear and intracytoplasmic inclusions and Owl’s eye inclusion. This case highlights the differential diagnosis and histopathological characteristics of gastrointestinal CMV infection and laboratory tests.
CONCLUSION
Extensive gastrointestinal CMV lesions can be induced by the immune suppression secondary to measles infection. Rational, fast, and effective laboratory examinations are essential for suspected patients.
Core Tip: We report a case of gastrointestinal cytomegalovirus (CMV) disease secondary to measles infection in a 9-mo-old Chinese boy who had extensive gastrointestinal lesions; the diagnosis was confirmed by histopathological analysis. His condition was improved by ganciclovir treatment. This case highlights the differential diagnosis and histopathological characteristics of gastrointestinal CMV infection and laboratory tests and sheds light on the difficulty in diagnosing gastrointestinal CMV disease due to its nonspecific clinical presentation and the weak diagnostic value of serologic antibody detection.
