Cytomegalovirus Colitis in a Critically Ill Patient Following Severe Legionella Pneumonia with Multiple Organ Failure

A 68-year-old man visited an emergency department complaining of dyspnea. He was diagnosed to have Legionella pneumonia with multiple organ failure. Although his multiple organ failure improved, he suffered from persistent abdominal pain and diarrhea with continuous minor bleeding. Colonoscopy revea...

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Bibliographic Details
Published in:Internal Medicine 2016, Vol.55(5), pp.527-531
Main Authors: Nakashima, Kei, Aoshima, Masahiro, Suzuki, Fumi, Watanabe, Junko, Otsuka, Yoshihito
Format: Article
Language:English
Subjects:
Abdominal Pain - diagnosis
Abdominal Pain - etiology
Abdominal Pain - therapy
Aged
Antiviral Agents - therapeutic use
Colitis - diagnosis
Colitis - drug therapy
Colitis - physiopathology
Colonoscopy
Colostomy
Critical Illness
critically ill patient
Cytomegalovirus
Cytomegalovirus - isolation & purification
cytomegalovirus antigenemia
cytomegalovirus colitis
Cytomegalovirus Infections - diagnosis
Cytomegalovirus Infections - drug therapy
Cytomegalovirus Infections - physiopathology
Diagnosis, Differential
Diarrhea - diagnosis
Diarrhea - etiology
Diarrhea - therapy
Ganciclovir - therapeutic use
Humans
Legionella
Legionella - isolation & purification
Legionella pneumonia
Legionnaires' Disease - complications
Legionnaires' Disease - diagnosis
Legionnaires' Disease - physiopathology
Male
Multiple Organ Failure - diagnosis
Multiple Organ Failure - drug therapy
Multiple Organ Failure - etiology
Pneumonia - diagnosis
Pneumonia - etiology
Pneumonia - physiopathology
Treatment Outcome
Citations: Items that this one cites
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Description
Summary:A 68-year-old man visited an emergency department complaining of dyspnea. He was diagnosed to have Legionella pneumonia with multiple organ failure. Although his multiple organ failure improved, he suffered from persistent abdominal pain and diarrhea with continuous minor bleeding. Colonoscopy revealed a longitudinal ulcer of the rectum, below the peritoneal reflection. He was diagnosed with cytomegalovirus (CMV) colitis. Antiviral therapy with ganciclovir was initiated. He finally underwent a colostomy after a bowel stricture caused an intestinal outlet obstruction, which made oral intake impossible. Based on the present case, we believe that CMV colitis must be considered as one of the differential diagnoses when critically ill patients develop continuous diarrhea and abdominal pain.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.55.4857