Cytomegalovirus Ileitis in a Patient With Post-severe Trauma: A Case Report.

IF 1.8 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL In vivo Pub Date : 2024-09-01 DOI:10.21873/invivo.13731

Yi-Yen Tsai, Jeng-Wei Lu, Chih-Chien Wang

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Abstract

Background/aim: The mortality rate for alimentary tract hemorrhage remains high due to a variety of contributing factors. In this report, we present a case of post-severe trauma patient with life-threatening gastrointestinal bleeding caused by cytomegalovirus (CMV)-induced damage to the terminal ileum.

Case report: A 76-year-old female with a history of hypertension and gastrointestinal bleeding developed CMV ileitis post-severe trauma. Despite negative CMV IgM antibodies, PCR testing confirmed CMV infection in the biopsy tissue. Histopathological examination revealed viral inclusion bodies, with immunohistochemistry confirming CMV presence.

Results: Intravenous ganciclovir effectively managed symptoms and halted bleeding. CMV ileitis, typically seen in immunocompromised states, may occur sporadically in immunocompetent individuals, including post-orthopedic surgery patients. The exact mechanism remains unclear, possibly related to surgical stress. Diagnosis relies on histopathology and immunohistochemistry.

Conclusion: Early recognition and treatment are vital for optimal outcomes, emphasizing the need for awareness among orthopedic surgeons regarding CMV as a potential cause of postoperative complications.

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严重创伤后患者的巨细胞病毒性回肠炎：病例报告。

背景/目的：由于多种诱因，消化道出血的死亡率一直居高不下。在本报告中，我们介绍了一例严重创伤后患者因巨细胞病毒（CMV）引起的回肠末端损伤而导致的危及生命的消化道出血：一名有高血压和消化道出血病史的 76 岁女性在严重创伤后患上了 CMV 回肠炎。尽管 CMV IgM 抗体呈阴性，但 PCR 检测证实活检组织中存在 CMV 感染。组织病理学检查发现了病毒包涵体，免疫组化证实了 CMV 的存在：结果：静脉注射更昔洛韦有效控制了症状并止住了出血。CMV 回肠炎通常见于免疫功能低下的状态，但也可能偶发于免疫功能正常的个体，包括矫形手术后的患者。确切的发病机制尚不清楚，可能与手术应激有关。诊断依赖于组织病理学和免疫组化：结论：早期识别和治疗对获得最佳疗效至关重要，强调骨科医生需要认识到 CMV 是导致术后并发症的潜在原因。

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来源期刊

In vivo 医学-医学：研究与实验

CiteScore

4.20

自引率

4.30%

发文量

330

审稿时长

3-8 weeks

期刊介绍： IN VIVO is an international peer-reviewed journal designed to bring together original high quality works and reviews on experimental and clinical biomedical research within the frames of physiology, pathology and disease management. The topics of IN VIVO include: 1. Experimental development and application of new diagnostic and therapeutic procedures; 2. Pharmacological and toxicological evaluation of new drugs, drug combinations and drug delivery systems; 3. Clinical trials; 4. Development and characterization of models of biomedical research; 5. Cancer diagnosis and treatment; 6. Immunotherapy and vaccines; 7. Radiotherapy, Imaging; 8. Tissue engineering, Regenerative medicine; 9. Carcinogenesis.