Year 2022 / Volume 114 / Number 5
Letter
Cytomegalovirus associated rectal ulcer as a manifestation of primary HIV infection

308

DOI: 10.17235/reed.2022.8546/2021

Silvia Espina Cadena, Elena del Valle Sanchez, Yolanda Martínez Santos, María Badía Martínez, Patricia Camo Monterde,

Abstract
We present the case of a 40-year-old male sent for fatigue, mild weight loss and rectal bleeding for 2 months, neither fever nor diarrhea. He referred unprotected intercourse. Blood test revealed mild elevation of transaminases. We requested serologies, with positive CMV IgG and CMV plasma levels of 47UI/ml (PCR), and a negative result of the rest of hepatotropic viruses. Abdominal ultrasound was normal and during colonoscopy we observed an ulcer in lower rectum, with negative biopsies for malignancy and a positive immunohistochemistry (IHC) for CMV. We amplified the serologic analysis and detected positive antibodies for the human immunodeficiency virus (HIV), with a viral load of 50500 copies/ml, negative p24 antigen and CD4+ cell count of 900 cells/mm3 (30%). Rest of serologies and triple-site testing were negative. We referred the patient to the infectious disease consultation and they started antiretroviral therapy (ART). We decided a watchful waiting approach for the rectal ulcer with close endoscopic follow-up, with early healing and complete resolution.
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References
1. Pintos Pascual I, Muñez Rubio E, Ramos Martínez A. Complicaciones infecciosas en el paciente con infección por el VIH. Medicine - Programa de Formación Médica Continuada Acreditado. 2018;12(56):3306-13.
2. Garcés Molina FJ, Royo García A, Hernández Pérez G, Pinilla B, Pastor Gómez-Cornejo L, Portugal Álvarez J. Diarrea por citomegalovirus (CMV) como primera manifestación de sida %J Anales de Medicina Interna. 2000;17:31-2.
3. Marques O, Jr., Averbach M, Zanoni EC, Corrêa PA, Paccos JL, Cutait R. Cytomegaloviral colitis in HIV positive patients: endoscopic findings. Arquivos de gastroenterologia. 2007;44(4):315-9.
4. Smith PR, Glynn M, Sheaff M, Aitken C. CMV colitis in early HIV infection. International journal of STD & AIDS. 2000;11(11):748-50.
5. Paparone PP, Paparone PA. Cytomegalovirus Colitis in a Human Immunodeficiency Virus-Positive Patient With a Normal CD4 Count. The American Journal of the Medical Sciences. 2012;344(6):508-10.
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Espina Cadena S, del Valle Sanchez E, Martínez Santos Y, Badía Martínez M, Camo Monterde P. Cytomegalovirus associated rectal ulcer as a manifestation of primary HIV infection. 8546/2021


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Publication history

Received: 22/12/2021

Accepted: 19/01/2022

Online First: 24/01/2022

Published: 06/05/2022

Article Online First time: 33 days

Article editing time: 135 days


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