Cytomegalovirus colitis

Cytomegalovirus colitis

    * Introduction
    * Pathogenesis
    * Symptoms and Diagnosis
    * Treatment
Citomegalus virus is a member of Herpesviridae family, along with herpes simplex virus 1 and 2, Epstein-Barr virus and varicella-zoster virus. It is a double strand of DNA virus and lipoprotein envelope. Like other herpes CMV is icosahedral and replicates in the host nucleus. Like other members of this family is able to produce cytomegalovirus latent infection. Replication in the host cell intranuclear inclusions is represented by large and small cytoplasm. The virus preferentially grows in fibroblast cells.
Studies show that approximately 50-80% of the world population is seropositive for cytomegalovirus. With the use of immunosuppressive agents and increasing HIV infection in 1980, a new class of cytomegalovirus infection has been described. Retinitis, adrenalita, pneumonitis, colitis and esophagitis are some of the infections seen in immunosuppressed hosts. Cytomegalovirus is the third most common pathogen in patients with AIDS, ahead of Pneumocystis carinii and Candida.
Gastrointestinal cytomegalovirus disease was described in 1960. Cytomegalovirus colitis is the second leading cause of infection encountered in patients with cytomegalovirus retinitis after AIDS. Among AIDS patients who have gastrointestinal infections caused by cytomegalovirus, 67% shows and colon involvement. Cytomegalovirus colitis is rare in patients who are severely immunosuppressed. Gastrointestinal Damage can occur alone or in disseminated disease.
Cytomegalovirus may complicate steroid-dependent ulcerative colitis. Patients with steroid-dependent ulcerative colitis who have refractory disease should be evaluated for infection with cytomegalovirus. Up to 59% of the patients with colitis were diagnosed simultaneously with cytomegalovirus infection. The prognosis for patients with ulcerative colitis complicated by cytomegalovirus infection is negative only patients with ulcerative colitis.
Patients with fever, anorexia, weight loss, dehydration, abdominal pain, abdominal distension, nausea, watery diarrhea with blood or chronic constipation. Therapy for patients with HIV infection include strong antiviral administration. Cytomegalovirus colitis patients after antiretroviral therapy have benefits. Patients with other types of immunosuppression benefit of ganciclovir. Surgical resection should be indicated only in patients with severe ischaemia or uncontrollable bleeding.
Cytomegalovirus colitis complications include necrotizing colitis and toxic megacolon, perforation, sepsis, peritonitis and death. Once diagnosed patients with these complications have a negative prognosis. When it is indicated colony generous resection to prevent perforation and sepsis. With the rapid diagnosis and prognosis of patients with appropriate antiviral therapy of cytomegalovirus colitis is good. In patients without imunocompromitere, the prognosis appears to be age dependent, with patients over 55 years with a high mortality.