Case Report
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Apr 21, 2021; 27(15): 1655-1663
Published online Apr 21, 2021. doi: 10.3748/wjg.v27.i15.1655
Gastrointestinal cytomegalovirus disease secondary to measles in an immunocompetent infant: A case report
Qing-Hua Yang, Xiao-Peng Ma, Dong-Ling Dai, Da-Ming Bai, Yu Zou, Si-Xi Liu, Jian-Ming Song
Qing-Hua Yang, Xiao-Peng Ma, Dong-Ling Dai, Da-Ming Bai, Yu Zou, Si-Xi Liu, Endoscopy Center and Gastroenterology Department, Shenzhen Children's Hospital, Shenzhen 518036, Guangdong Province, China
Jian-Ming Song, Department of Pathology, Shenzhen Children's Hospital, Shenzhen 518036, Guangdong Province, China
Author contributions: Yang QH drafted the manuscript and analyzed the data; Liu SX, Bai DM, and Zou Y were involved in patient management and follow-up; Dai DL and Ma XP designed and supervised the study; Song JM contributed to data acquisition, analysis, and interpretation; Dai DL and Ma XP contributed equally to this manuscript; all of the authors approved the submission of this manuscript.
Supported by Shenzhen Innovation and Technology Committee, No. JCYJ20180228175150018.
Informed consent statement: Consent was obtained from the parents of the patient for publication of the case report and any accompanying images.
Conflict-of-interest statement: The authors who took part in this study declare that they do not have anything to disclose regarding funding or a conflict of interest with respect to this manuscript.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Dong-Ling Dai, MD, PhD, Chief Doctor, Professor, Endoscopy Center and Gastroenterology Department, Shenzhen Children's Hospital, No. 7019 Yitian Road, Futian District, Shenzhen 518036, Guangdong Province, China. daidong3529@sina.com
Received: January 14, 2021
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
Abstract
BACKGROUND

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.

CASE SUMMARY

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.

CONCLUSION

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.

Keywords: Cytomegalovirus, Diarrhea, Gastrointestinal, Infant, Measles, Case report

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.