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dc.contributor.authorLee, Chun-Yuanen_US
dc.contributor.authorChen, Yen-Hsuen_US
dc.contributor.authorLu, Po-Liangen_US
dc.date.accessioned2019-04-03T06:35:50Z-
dc.date.available2019-04-03T06:35:50Z-
dc.date.issued2017-02-01en_US
dc.identifier.issn1471-2334en_US
dc.identifier.urihttp://dx.doi.org/10.1186/s12879-017-2218-yen_US
dc.identifier.urihttp://hdl.handle.net/11536/145065-
dc.description.abstractBackground: Reactivated cytomegalovirus (CMV) infection has been known to cause significant morbidity and mortality in immunocompromised patients. However, CMV disease rarely develops in immunocompetent patients, and reported cases often present with a mild, self-limiting course, without severe life-threatening sequelae. While the colon is the most common gastrointestinal site affected by CMV disease in immunocompetent patients, rectal involvement is rarely reported. CMV proctitis can present in two distinct forms, primary and reactivated. However, reactivated CMV proctitis is rarely reported as a causative etiology of nosocomial diarrhea, except in transplant patients. Herein we present a case of reactivated CMV proctitis in an immunocompetent patient, presenting as nosocomial diarrhea. Previously reported cases of reactivated CMV proctitis in immunocompetent patients are also reviewed. Case presentation: A 79-year-old female was admitted because of metabolic encephalopathy caused by dehydration and hypernatremia. The patient's consciousness level returned rapidly after fluid supplementation. However, she subsequently presented with abdominal pain and diarrhea on day 8 of admission. Abdominal contrast-enhanced computed tomography on day 10 of admission demonstrated inflammation around the rectum, suggesting proctitis. Colonoscopy on day 16 of admission showed a giant ulcer at the rectum. Pathology of rectal biopsy confirmed CMV infection. The patient recovered without sequelae after 38 days of valganciclovir treatment. Follow-up colonoscopy revealed a healed ulcer over the rectum. Ten cases in the literature, plus our case, with reactivated CMV proctitis in immunocompetent patients were reviewed. We found that most patients were elderly (mean, 72 years) with a high prevalence of diabetes mellitus (54.5%). Cardinal manifestations are often non-specific (diarrhea, hematochezia, tenesmus), and eight (72.7%) developed CMV proctitis following a preceding acute, life-threatening disease, rather than as an initial presentation on admission. These manifestations frequently develop during hospitalization, and are thus often regarded as nosocomial diarrhea. Conclusions: Clinicians should be aware of the possibility of nosocomial onset of reactivated CMV proctitis in patients hospitalized due to a preceding critical illness, although the benefits of antiviral therapy remain unclear.en_US
dc.language.isoen_USen_US
dc.subjectCase reporten_US
dc.subjectCytomegalovirusen_US
dc.subjectImmunocompetenten_US
dc.subjectProctitisen_US
dc.titleReactivated cytomegalovirus proctitis in an immunocompetent patient presenting as nosocomial diarrhea: a case report and literature reviewen_US
dc.typeArticleen_US
dc.identifier.doi10.1186/s12879-017-2218-yen_US
dc.identifier.journalBMC INFECTIOUS DISEASESen_US
dc.citation.volume17en_US
dc.citation.spage0en_US
dc.citation.epage0en_US
dc.contributor.department生物科技學系zh_TW
dc.contributor.departmentDepartment of Biological Science and Technologyen_US
dc.identifier.wosnumberWOS:000397382300001en_US
dc.citation.woscount1en_US
Appears in Collections:Articles


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