Cytomegalovirus (CMV) can cause severe, persistent, and even life-threatening diseases also affecting the gastrointestinal system in immunosuppressed individuals. Focal mucosal ulcerations and pseudopolyps were observed in the colonoscopy performed because of exacerbation of abdominal pain and bloody stools in a 71-year-old female followed by Gastroenterology Outpatient Clinic with ulcerative colitis for 7 years. Histomorphologic findings were compatible with ulcerative colitis. CMV antigen-positive cells were detected in immunohistochemistry studies. CMV DNA detected as 257 000 copy/mg in tissue biopsy, and 137 copy/ml in serum using polymerase chain reaction test. After a one-month treatment of ganciclovir 2×5 mg/kg IV, CMV DNA was negative in tissue and serum. She was discharged with partial improvement to complete oral valganciclovir in three months. Because of the incompatibility to the therapy, she was hospitalized three months later, with complaints of recurring abdominal pain and bloody stools. Colonic biopsy revealed CMV DNA 814 copy/mg, and methyprednisolone and ganciclovir were started. Infliximab (IFX) was added because of no response to the treatment. With this regimen, when the patient’s tissue and serum CMV DNA became negative and her clinic picture improved, ganciclovir treatment was stopped, and she was discharged to continue the IFX treatment. During her 6-month of follow up, no new attack was developed. This case also shows that in patients with ulcerative colitis CMV colitis should be kept in mind that it has similar findings with ulcerative colitis as an opportunistic infection.

Klimik Dergisi 2020; 33(3): 320-3.

Cite this article as: Akdoğan Ö, Yapar D, Düzenli T, et al. [Cytomegalovirus colitis in a patient with ulcerative colitis]. Klimik Derg. 2020; 33(3): 230-3. Turkish.