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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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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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