Cytomegalovirus colitis in patients without inflammatory bowel disease: a single center study

Scand J Gastroenterol. 2010 Nov;45(11):1295-301. doi: 10.3109/00365521.2010.499962. Epub 2010 Jun 23.


Objective: Cytomegalovirus (CMV) aggravates preexisting inflammatory bowel disease (IBD), and there are numerous reports of CMV colitis in IBD patients. However, little attention has been paid to CMV colitis in non-IBD patients. The aim was to determine the clinical manifestations, endoscopic appearance, and clinical course of CMV colitis in non-IBD patients.

Material and methods: We reviewed medical records of patients diagnosed with CMV colitis based on immunohistochemical studies of biopsy specimens or surgical specimens between 1998 and 2009.

Results: The medical records of 43 patients were reviewed. Subjects included individuals with AIDS, and those undergoing chemotherapy, steroid therapy, or transplantation, as well as individuals with other co-morbidities and individuals with no previous illnesses. Frequent symptoms were non-bloody diarrhea, abdominal pain, fever, and hematochezia. Macroscopically normal rectosigmoid mucosa was observed in eight of 21 patients who underwent full-length colonoscopy. Endoscopic findings were varied, and included macroscopically normal (n = 2), colitis alone (n = 12), ulcer alone (n = 5), and ulcer with colitis (n = 22). The ulcer margin was well-circumscribed in 12 of 21 patients. Thirty-six patients were administered antiviral agents and two patients died. All patients who were not treated with an antiviral agent recovered spontaneously while waiting for their biopsy results.

Conclusions: Colonoscopy is preferred to sigmoidoscopy for diagnosis of CMV colitis. Antiviral therapy should not be mandatory for a subset of patients with CMV colitis.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, Viral / analysis
  • Antiviral Agents / therapeutic use
  • Biopsy
  • Child
  • Child, Preschool
  • Colitis / diagnosis*
  • Colitis / drug therapy
  • Colitis / virology
  • Colonoscopy / methods*
  • Cytomegalovirus / genetics
  • Cytomegalovirus / immunology
  • Cytomegalovirus Infections / diagnosis*
  • Cytomegalovirus Infections / drug therapy
  • Cytomegalovirus Infections / virology
  • DNA, Viral / analysis
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Humans
  • Inflammatory Bowel Diseases
  • Intestinal Mucosa / pathology*
  • Intestinal Mucosa / virology
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Young Adult


  • Antigens, Viral
  • Antiviral Agents
  • DNA, Viral