Cytomegalovirus colitis in intensive care unit patients: Difficulties in clinical diagnosis.

doi:10.1016/j.jcrc.2014.01.003

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標題:	Cytomegalovirus colitis in intensive care unit patients: Difficulties in clinical diagnosis.
作者:	Chan, Khee-Siang Yang, Chun-Chieh Chen, Chin-Ming Yang, His-Hsing Lee, Ching-Chien Chuang, Yin-Ching Yu, Wen-Liang
貢獻者:	保健營養系
關鍵字:	Cytomegalovirus colitis Acute hemorrhagic rectal ulcer Immunohistochemical stain Polymerase chain reaction Pseudomembranous colitis
日期:	2014-06
上傳時間:	2015-05-06 21:19:50 (UTC+8)
出版者:	W B Saunders Co-Elsevier Inc
摘要:	Purpose: Cytomegalovirus (CMV) infection occurs increasingly in critically ill patients in intensive care units (ICUs). We reported CMV colitis which has rarely been recognized in the ICU patients. Methods: CMV DNA was detected by polymerase chain reaction (PCR) for blood and/or stool samples. Definite diagnosis of CMV colitis required histopathology or CMV immunohistochemical staining of colorectal biopsies. We reviewed ICU patients characterized by positiveblood or stool CMV-PCR with colorectal bleeding or water diarrhea. Results: We identified 18 patients (biopsy-proved, n = 8; probable cases, n = 10). The most common comorbidities were chronic renal disease, diabetes mellitus, and coronary artery disease. Stool CMV-PCR was positive in 7 of 10 patients (2 of 3 biopsy-proved and 5 of 7 probable cases). Colonoscopy was performed for 15 patients, revealing ulcerative or polypoid lesions. The endoscopists obtained colonic biopsies from 9 patients. Yet, the pathologists reported CMV colitis for 4 patients. Additional 4 patients were confirmed using immunohistochemical stain by the request of clinical physicians. Pseudomembranous colitis was found in 4 patients. Conclusion: Diagnosis of CMV colitis seems difficult in clinical practice and need persistent communication between clinicians. The positive stool CMV-PCR result was a useful hint for adding immunohistochemical stain in mucosal biopsies to make a definite diagnosis of CMV colitis. (C) 2014 Elsevier Inc. All rights reserved.
關聯:	Journal of Critical Care, v.29 n.3, 4740
顯示於類別:	[保健營養系(所) ] 期刊論文

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