An Elderly Case of Cytomegalovirus Enterocolitis Associated with a Malignant Tumor

Abstract

An 83-year-old man was given a diagnosis of left parotid cancer in our hospital in November 1997. He refused to undergo a surgical procedure because of his advanced age. Therefore chemotherapy and radiotherapy were used. Chemotherapy with CAP (Cyclophosphamide, Adriacin, and CDDP) was conducted on 6 occasions between December 1997 to July 2000. Prednisolone (15mg) was administered daily from July 15, 2000. The patient started suffering from diarrhea on August 2, 2000. As the patient also began to suffer high grade fevers and stomachaches, he was admitted on a diagnosis of acute enterocolitis. He had bloody stool on August 11. On emergency colonoscopy, an ulceration with bleeding was located in the lower rectum. The biopsy specimen revealed intranuclear inclusion bodies and positively staining cells for monoclonal antibody to cytomegalovirus through the immunohistochemical technique, and it was diagnosed as cytomegalovirus enterocolitis. He was treated with ganciclovir. One month later, his clinical symptoms had improved.
Cytomegalovirus enterocolitis is an opportunistic infection, so immunocompromised hosts (such as cancer patients, patients using immunosuppressants, old people) have a greater probability of contracting cytomegalovirus infection. A ganciclovir is an effective treatment. A cytomegalovirus enterocolitis should considered in the differential diagnosis of enterocolitis, when alimentary symptoms like diarrhea or bloody stool are found in immunocompromised hosts.