American Journal of Medical Case Reports
ISSN (Print): 2374-2151 ISSN (Online): 2374-216X Website: http://www.sciepub.com/journal/ajmcr Editor-in-chief: Samy, I. McFarlane
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American Journal of Medical Case Reports. 2021, 9(1), 75-77
DOI: 10.12691/ajmcr-9-1-19
Open AccessCase Report

Cytomegalovirus Colitis Leading to Recto-vaginal Fistula in Immunocompetent Patien

Shrikant D Pande1, , Sherry H Y Young1, Ramesh Wijaya1, Seow Yen Tan1, Aye Aye Khine1 and May Myat Win1

1Changi General Hospital, Singapore

Pub. Date: November 20, 2020

Cite this paper:
Shrikant D Pande, Sherry H Y Young, Ramesh Wijaya, Seow Yen Tan, Aye Aye Khine and May Myat Win. Cytomegalovirus Colitis Leading to Recto-vaginal Fistula in Immunocompetent Patien. American Journal of Medical Case Reports. 2021; 9(1):75-77. doi: 10.12691/ajmcr-9-1-19

Abstract

Cytomegalovirus (CMV) is a double-stranded DNA virus member of Herpesviridae family. Majority of the population is exposed to CMV, based on sero-prevalence. CMV establishes latent infection and may re-activate later and cause significant clinical manifestations, especially in immunocompromised patients, like those on immunosuppressant drugs and chemotherapy, post organ transplantation and acquired immunodeficiency syndrome. The clinical manifestations of CMV in immunocompetent people are due to primary infection and vary from mild and self-limiting to severe and debilitating. CMV colitis in immune-competent people is uncommon. The complication of CMV infection leading to colonic perforation and recto-vaginal fistula is rare in immunocompetent subjects. We report case 67 year old female who was admitted with road traffic accident with tibia and T10 vertebral fracture without any abdominal injury. She underwent spinal fixation. She later developed diarrhea with abdominal pain. Whilst investigations were underway, she developed signs of intestinal obstruction. Urgent CT scan of abdomen and pelvis confirmed intestinal obstruction with rectal perforation. Urgent laparotomy was done which confirmed diagnosis of recto-vaginal iula. Adhesiolysis and Hartmann¡¯s procedure was performed. Intraoperative biopsy specimen of the rectum confirmed the diagnosis of CMV. She recovered after undergoing rehabilitation and treatment with Ganciclovir. She is awaiting reversal of colostomy.

Keywords:
CMV fistula immunocompetent immunocompromised

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