Case Report
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Feb 6, 2020; 8(3): 552-559
Published online Feb 6, 2020. doi: 10.12998/wjcc.v8.i3.552
Cytomegalovirus ileo-pancolitis presenting as toxic megacolon in an immunocompetent patient: A case report
Joon Hyun Cho, Joon Hyuk Choi
Joon Hyun Cho, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, Daegu 42415, South Korea
Joon Hyuk Choi, Department of Pathology, Yeungnam University College of Medicine, Daegu 42415, South Korea
Author contributions: Cho JH designed the report; Cho JH and Choi JH diagnosed the case; Cho JH treated the patient; Cho JH and Choi JH collected the patient’s clinical data; Cho JH analyzed the data and wrote the manuscript.
Supported by the 2019 Yeungnam University Research Grant.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and accompanying images.
Conflict-of-interest statement: The authors have no conflict of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised accordingly.
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: Joon Hyun Cho, MD, PhD, Assistant Professor, Doctor, Division of Gastroenterology and Hepatology, Department of Internal Medicine, Yeungnam University College of Medicine, 170 Hyeonchung-ro, Nam-gu, Daegu 42415, South Korea. ygowgo96@yu.ac.kr
Received: July 2, 2019
Peer-review started: July 12, 2019
First decision: September 9, 2019
Revised: October 13, 2019
Accepted: October 30, 2019
Article in press: October 30, 2019
Published online: February 6, 2020
Processing time: 219 Days and 19.5 Hours
Core Tip

Core tip: Cytomegalovirus (CMV) enterocolitis presenting as toxic megacolon in an immunocompetent patient is rarely encountered. We report the case of a 70-year-old male with a non-immunocompromised state that presented with toxic megacolon and subsequently developed massive hemorrhage as a complication of CMV ileo-pancolitis. Although the diagnosis was delayed until massive hematochezia developed, the patient was treated successfully by repeat colonoscopic decompression and intravenous ganciclovir. A high degree of clinical suspicion is required to diagnose CMV enterocolitis, especially in immunocompetent patients, and this condition should be considered as a possible differential diagnosis in patients with intractable symptoms of enterocolitis or megacolon of unknown cause.