Cytomegalovirus associated rectal ulcer as manifestation of primary HIV infection

Espina Cadena, Silvia ; del Valle Sanchez, Elena ; Martínez Santos, Yolanda (Universidad de Zaragoza) ; Badía Martínez, María ; Camo Monterde, Patricia

Resumen: 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.

Idioma: Inglés

DOI: 10.17235/reed.2022.8546/2021

Año: 2022

Publicado en: REVISTA ESPANOLA DE ENFERMEDADES DIGESTIVAS 114, 5 (2022), 308-309
ISSN: 1130-0108

Factor impacto JCR: 2.0 (2022)

Categ. JCR: GASTROENTEROLOGY & HEPATOLOGY rank: 81 / 93 = 0.871 (2022) - Q4 - T3

Factor impacto CITESCORE: 1.9 - Medicine (Q3)

Factor impacto SCIMAGO: 0.269 - Medicine (miscellaneous) (Q3) - Gastroenterology (Q3)

Tipo y forma: (Versión definitiva)

Área (Departamento): Área Enfermería (Dpto. Fisiatría y Enfermería)