Published online Apr 21, 2021. doi: 10.3748/wjg.v27.i15.1655
Peer-review started: January 14, 2021
First decision: February 10, 2021
Revised: February 19, 2021
Accepted: March 25, 2021
Article in press: March 25, 2021
Published online: April 21, 2021
Gastrointestinal cytomegalovirus (CMV) disease occurs commonly in immunocompromised/immunodeficient patients with advanced human immunodeficiency virus infection, neoplasm, solid organ transplantation, hematopoietic stem cell transplantation, or treatment with immunosuppressants, but is rarely reported in association with measles infection.
We describe a case of extensive gastrointestinal CMV disease secondary to measles infection in a 9-mo-old boy who presented with persistent fever and bloody diarrhea. His condition was improved after ganciclovir treatment. Serological analysis of CMV showed negative immunoglobulin (Ig) M and positive IgG. Blood CMV-DNA was 9.26 × 103 copies/mL. The diagnosis of gastrointestinal CMV disease was confirmed by histopathological findings of intranuclear and intracytoplasmic inclusions and Owl’s eye inclusion. This case highlights the differential diagnosis and histopathological characteristics of gastrointestinal CMV infection and laboratory tests.
Extensive gastrointestinal CMV lesions can be induced by the immune suppression secondary to measles infection. Rational, fast, and effective laboratory examinations are essential for suspected patients.
Core Tip: We report a case of gastrointestinal cytomegalovirus (CMV) disease secondary to measles infection in a 9-mo-old Chinese boy who had extensive gastrointestinal lesions; the diagnosis was confirmed by histopathological analysis. His condition was improved by ganciclovir treatment. This case highlights the differential diagnosis and histopathological characteristics of gastrointestinal CMV infection and laboratory tests and sheds light on the difficulty in diagnosing gastrointestinal CMV disease due to its nonspecific clinical presentation and the weak diagnostic value of serologic antibody detection.