The clinical spectrum of cytomegalovirus colitis in adults

<jats:title>Summary</jats:title><jats:p><jats:bold>Background </jats:bold> Colonic cytomegalovirus reactivation rarely occurs in adults without inflammatory bowel disease or a known immunosuppressive state.</jats:p><jats:p><jats:bold>Aim </jats:bold> To describe our experience with such patients.</jats:p><jats:p><jats:bold>Methods </jats:bold> All consecutive admissions of patients with possible cytomegalovirus colitis, between 1995 and 2006, were reviewed retrospectively.</jats:p><jats:p><jats:bold>Results </jats:bold> Nineteen patients were studied. Most of the patients were elderly with multiple co‐morbidities. Three main forms of disease presentation were recognized: acute diarrhoea, chronic diarrhoea and lower gastrointestinal bleeding. Colonic mucosal intranuclear inclusion bodies were found in 12 patients. Thirteen patients had cytomegalovirus viraemia (either by polymerase chain reaction and/or by white blood cell‐cytomegalovirus antigenaemia test). Ganciclovir therapy was given to only eight patients; only five of these patients survived. The other subgroup of 11 patients received only supportive therapy. Most of the patients from this subgroup had a prolonged and complicated hospital course; only nine patients survived. Follow‐up colonoscopies were performed only in five patients (out of the 14 patients who survived). In four of these patients, chronic mucosal inflammatory changes were noted.</jats:p><jats:p><jats:bold>Conclusions </jats:bold> Cytomegalovirus colitis occurs rarely in adult individuals. The disease may have various and multiple acute and/or chronic clinical manifestations. Clinical awareness of this condition is needed.</jats:p>