657. Gastrointestinal Infection by Cytomegalovirus in Immunocompetent Patient: casuistry 10 years
Session: Poster Abstract Session: Oh, Those Pesky Viruses!
Thursday, October 27, 2016
Room: Poster Hall
Posters
  • Nº 657.pdf (209.1 kB)
  • Background: 

    Gastrointestinal Cytomegalovirus (GI CMV) infection is unusual in immunocompetent host and the most involved site is the colon.

    The objective of the study was to evaluate clinical presentation, diagnosis and evolution of GI CMV infection in immunocompetent patient.

    Methods: 

    Study: retrospective, observational.

    Data was extracted from immunocompetent inpatients’ medical charts with GI CMV infection at a university hospital from 01/ 01/ 2006 to 12/ 31/ 2014.

    We evaluated age and sex, previous abdominal pathology, symptoms related to GI CMV infection, treatment and mortality at 30 days.

    Definitions:

    GI CMV infection: symptoms from upper or lower gastrointestinal tract and findings of macroscopic mucosal lesions on endoscopy and demonstration of CMV infection (by culture, histopathology testing, immune-histochemical analysis, or in situ hybridization) in a gastrointestinal tract biopsy specimen.


    Results:

    Six patients were included, 2 males (30 and 73 years) and 4 females (18, 80, 84 and 90 years).

    Previous abdominal pathology in five patients: diverticular disease 1, intestinal surgery 1, duodenal ulcers 1, intestinal polyposis and desnutrition 1.

    Symptoms of CMV infection were hematochezia in 4 patients (67%), abdominal pain in one patient (17%) and one intestinal obstruction (17%).

    Endoscopic findings: ulcers in 5 patients (83%) and intestinal polyp in one patient. Histological findings were intra-nuclear and/or cytoplasm inclusions. Immunohistochemistry techniques were performed and confirm diagnosis in all of them.

    No patient had other site involved.

    Four patients were treated with ganciclovir. Two of them required intestinal resection due to perforation and both survived. Among the other two patients, one died.

    Two patients did not receive any treatment at all and survived. Mortality at 30 days was 17% (1/6).

    Conclusion: 

    -Hematochezia was the prevalent symptom in GIs CMV in patients with unknown cause of immunosuppression.

    -Medical treatment could not be assessed due to the small sample size.

    -GI CMV infection should be considered like differential diagnosis in immune-competent adults with intestinal symptoms, especially with previous intestinal pathology.

    -Inmunoscenecence and desnutrition could be predisponent factors.

    Stella De Gregorio, MD, Karina Araujo, MD, Javier Farina, MD, Maria Avagnina, MD, Jorgelina Real, MD and Monica Foccoli, MD, Hospital de Clinicas "Jose de San Martin", Ciudad de Buenos Aires, Argentina

    Disclosures:

    S. De Gregorio, None

    K. Araujo, None

    J. Farina, None

    M. Avagnina, None

    J. Real, None

    M. Foccoli, None

    Findings in the abstracts are embargoed until 12:01 a.m. CDT, Wednesday Oct. 26th with the exception of research findings presented at the IDWeek press conferences.