Cytomegalovirus Colitis Followed by Colonic Pseudolipomatosis and Gastric Emphysema in a Post-resuscitation Patient

Masaya Iwamuro; Takehiro Tanaka; Nao Yamauchi; Yuri Nakashima; Takahira Wada; Sakiko Hiraoka; Yoshiro Kawahara; Hiroyuki Okada

doi:10.2169/internalmedicine.3633-19

CASE REPORTS

Cytomegalovirus Colitis Followed by Colonic Pseudolipomatosis and Gastric Emphysema in a Post-resuscitation Patient

Masaya Iwamuro, Takehiro Tanaka, Nao Yamauchi, Yuri Nakashima, Takahira Wada, Sakiko Hiraoka, Yoshiro Kawahara, Hiroyuki Okada

Author information

Masaya Iwamuro
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
Takehiro Tanaka
Department of Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
Nao Yamauchi
Center for Graduate Medical Education, Okayama University Hospital, Japan
Yuri Nakashima
Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
Takahira Wada
Department of Nephrology, Rheumatology, Endocrinology, and Metabolism, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
Sakiko Hiraoka
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan
Yoshiro Kawahara
Department of Practical Gastrointestinal Endoscopy, Okayama University Hospital, Japan
Hiroyuki Okada
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Japan

Keywords: cytomegalovirus colitis, pseudolipomatosis, gastric emphysema, post-resuscitation, diabetes mellitus

JOURNAL OPEN ACCESS

2020 Volume 59 Issue 4 Pages 519-525

DOI https://doi.org/10.2169/internalmedicine.3633-19

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Abstract

A 64-year-old Japanese man suffered cardiopulmonary arrest, which may have resulted from sepsis and/or hyperosmolar hyperglycemic non-ketonic coma, and was admitted after successful resuscitation. He had watery diarrhea on day 18 and was diagnosed with cytomegalovirus enterocolitis. In addition, computed tomography performed on day 27 and colonoscopy revealed gastric emphysema and intestinal pseudolipomatosis, respectively. This report is the first to describe a patient with cytomegalovirus enterocolitis and subsequent gastric emphysema and pseudolipomatosis. Gastrointestinal cytomegalovirus infection may underlie gastric emphysema and intestinal pseudolipomatosis, particularly in patients with relative or obvious immune dysfunction.

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