Biomaterial Database

Ileal perforation caused by cytomegalovirus infection in a critically ill adult. 2000

R S Chamberlain, and S Atkins, and N Saini, and J C White

Department of Surgery, Montefiore Medicial Center, Albert Einstein College of Medicine, Bronx, NY 10467, USA.

Cytomegalovirus (CMV) infection of the gastrointestinal (GI) tract is common and is most often seen in patients with acquired immunodeficiency syndrome (AIDS), inflammatory bowel disease, or those receiving immunosuppressive therapy. CMV infection of the small bowel accounts for only 4.3% of all CMV infections of the GI tract. Isolated cases of small bowel perforation due to CMV have been reported in AIDS patients, and all but one patient has died. This article reports the first case of an ileal perforation due to transfusion-associated CMV infection in a critically-injured non-AIDS patient. Immediate surgical resection and antiviral therapy led to complete recovery. The development of abdominal pain, fever, watery diarrhea, and GI bleeding in a critically ill patient should prompt the clinician to consider the diagnosis of CMV enteritis. If standard stool pathogens and Clostridium difficile toxin studies are nondiagnostic, endoscopic evaluation and CMV serology should be obtained. If CMV infection is confirmed, ganciclovir therapy should be initiated without delay. If bowel perforation occurs. prompt surgical resection is indicated. A heightened level of suspicion for CMV infection in multiply injured trauma victims and other critically ill patients, with earlier recognition of potential small bowel involvement, can hopefully decrease the incidence of bowel perforation, which is usually a fatal event.

UI	MeSH Term	Description	Entries
D007077	Ileal Diseases	Pathological development in the ILEUM including the ILEOCECAL VALVE.	Disease, Ileal,Diseases, Ileal,Ileal Disease
D007082	Ileum	The distal and narrowest portion of the SMALL INTESTINE, between the JEJUNUM and the ILEOCECAL VALVE of the LARGE INTESTINE.
D007416	Intestinal Perforation	Opening or penetration through the wall of the INTESTINES.	Intestinal Perforations,Perforation, Intestinal,Perforations, Intestinal
D008297	Male		Males
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D009104	Multiple Trauma	Multiple physical insults or injuries occurring simultaneously.	Injuries, Multiple,Trauma, Multiple,Wounds, Multiple,Multiple Injuries,Polytrauma,Injury, Multiple,Multiple Injury,Multiple Traumas,Multiple Wound,Multiple Wounds,Polytraumas,Traumas, Multiple,Wound, Multiple
D003586	Cytomegalovirus Infections	Infection with CYTOMEGALOVIRUS, characterized by enlarged cells bearing intranuclear inclusions. Infection may be in almost any organ, but the salivary glands are the most common site in children, as are the lungs in adults.	CMV Inclusion,CMV Inclusions,Congenital CMV Infection,Congenital Cytomegalovirus Infection,Cytomegalic Inclusion Disease,Cytomegalovirus Colitis,Cytomegalovirus Inclusion,Cytomegalovirus Inclusion Disease,Cytomegalovirus Inclusions,Inclusion Disease,Perinatal CMV Infection,Perinatal Cytomegalovirus Infection,Renal Tubular Cytomegalovirus Inclusion,Renal Tubular Cytomegalovirus Inclusions,Salivary Gland Virus Disease,Severe Cytomegalovirus Infection,Severe Cytomegalovirus Infections,Infections, Cytomegalovirus,CMV Infection, Congenital,CMV Infection, Perinatal,Colitis, Cytomegalovirus,Congenital CMV Infections,Congenital Cytomegalovirus Infections,Cytomegalic Inclusion Diseases,Cytomegalovirus Colitides,Cytomegalovirus Inclusion Diseases,Cytomegalovirus Infection,Cytomegalovirus Infection, Congenital,Cytomegalovirus Infection, Perinatal,Cytomegalovirus Infection, Severe,Cytomegalovirus Infections, Severe,Disease, Cytomegalic Inclusion,Disease, Cytomegalovirus Inclusion,Diseases, Cytomegalovirus Inclusion,Inclusion Disease, Cytomegalic,Inclusion Disease, Cytomegalovirus,Inclusion Diseases,Inclusion Diseases, Cytomegalovirus,Inclusion, CMV,Inclusion, Cytomegalovirus,Infection, Congenital CMV,Infection, Congenital Cytomegalovirus,Infection, Cytomegalovirus,Infection, Perinatal CMV,Infection, Perinatal Cytomegalovirus,Infection, Severe Cytomegalovirus,Perinatal CMV Infections,Perinatal Cytomegalovirus Infections
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D016638	Critical Illness	A disease or state in which death is possible or imminent.	Critically Ill,Critical Illnesses,Illness, Critical,Illnesses, Critical
D065227	Transfusion Reaction	Complications of BLOOD TRANSFUSION. Included adverse reactions are common allergic and febrile reactions; hemolytic (delayed and acute) reactions; and other non-hemolytic adverse reactions such as infections and adverse immune reactions related to immunocompatibility.	Delayed Hemolytic Transfusion Reaction,Acute Hemolytic Transfusion Reaction,Blood Transfusion-Associated Adverse Reactions,Delayed Serologic Transfusion Reaction,Febrile Non-Hemolytic Transfusion Reaction,Hemolytic Transfusion Reaction,Hypotensive Transfusion Reaction,Post-Transfusion Purpura,Posttransfusion Purpura,TAGHD,Transfusion-Associated Allergic Reaction,Transfusion-Associated Circulatory Overload,Transfusion-Associated Dyspnea,Transfusion-Associated Graft Vs. Host Disease,Transfusion-Transmitted Infection,Allergic Reaction, Transfusion-Associated,Blood Transfusion Associated Adverse Reactions,Circulatory Overload, Transfusion-Associated,Circulatory Overloads, Transfusion-Associated,Dyspnea, Transfusion-Associated,Febrile Non Hemolytic Transfusion Reaction,Hemolytic Transfusion Reactions,Infection, Transfusion-Transmitted,Post Transfusion Purpura,Posttransfusion Purpuras,Purpura, Post-Transfusion,Purpura, Posttransfusion,Reaction, Hemolytic Transfusion,Reaction, Hypotensive Transfusion,Reactions, Hemolytic Transfusion,Transfusion Associated Allergic Reaction,Transfusion Associated Circulatory Overload,Transfusion Associated Dyspnea,Transfusion Associated Graft Vs. Host Disease,Transfusion Reaction, Hemolytic,Transfusion Reaction, Hypotensive,Transfusion Reactions,Transfusion Reactions, Hemolytic,Transfusion Reactions, Hypotensive,Transfusion Transmitted Infection,Transfusion-Associated Circulatory Overloads,Transfusion-Transmitted Infections