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摘要


巨細胞病毒感染造成之大腸直腸炎,一般認爲發生在有免疫缺陷的人身上。在此報告一例有腹瀉及泌尿道感染、糖尿病控制不良的病人。大腸鏡檢查發現直腸前壁有多發性分枝狀潰瘍,證實爲巨細胞病毒引起,並在經過治療後一度改善。

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並列摘要


Cytomegalovirus (CMV) colitis is thought to occur almost exclusively in immunosup-pressed persons. Here we describe an unusual case of CMV proctitis in an 82-year-old male patient with diarrhea and uncontrolled diabetes mellitus, who had urinary tract infection and not received immunosuppressive therapy. Colonoscopy showed large ulcerations and sinus tracts involving the rectum. Improvement of proctitis was noted after treatment with Ganciclovir. CMV is a DNA virus and a member of the herpesvirus group. After an initial infection, the genome of the virus persists in the host and may later spontaneously become reactivated under conditions of immune compromise. Clinical significant CMV infections are usually found in patients in whom immunologic mechanisms have been altered or suppressed by neoplasia, chronic infections, immunosuppressive therapy, or AIDS^1. Alimentary tract CMV infections were reported as a first manifestation in acquired immunodeficiency syndrome^2. A few such occurrences have been reported in patients with diabetes mellitus(superscript 3,4). We here report the case of an elderly HI V-negative man with CMV proctitis diagnosed by the presence of CMV inclusions in biopsy specimens of the rectum.

並列關鍵字

cytomegalovirus proctitis diabetes mellitus

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