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Case Reports in Gastrointestinal Medicine
Volume 2014, Article ID 260120, 4 pages
http://dx.doi.org/10.1155/2014/260120
Case Report

Debilitating Chronic Diarrhea Caused by Generalized Gastrointestinal Cytomegalovirus Infection in an Immunocompetent Adult

1Department of Gastrointestinal Endoscopy, Bioclinic of Piraeus, 34 Filellinon Street, 18536 Piraeus, Greece
2Department of Gastroenterology, “Metaxa” Memorial Cancer Hospital of Piraeus, 51 Mpotasi Street, 18537 Piraeus, Greece

Received 18 March 2014; Accepted 1 June 2014; Published 12 June 2014

Academic Editor: Ian Craig Lawrance

Copyright © 2014 Emmanouil Telakis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Gastrointestinal cytomegalovirus (CMV) infection is a common opportunistic infection in immunocompromised patients, especially patients with acquired immunodeficiency syndrome and transplant recipients. In contrast, CMV infection of the gastrointestinal tract is rare in immunocompetent individuals. We report a case of severe, protracted, and debilitating diarrhea caused by generalized CMV infection of the gastrointestinal tract in an elderly woman with no apparent immunosuppression. An extensive diagnostic investigation demonstrated CMV-associated disease affecting both the upper and lower gastrointestinal tracts (esophagus, small intestine, and colon). Such extensive simultaneous involvement of the alimentary tract in an immunocompetent patient is rare and presents a diagnostic and therapeutic challenge. The diagnosis was based on a combination of endoscopic, histopathological, serological, and polymerase chain reaction analysis findings and our patient was successfully treated with intravenous ganciclovir. Our case demonstrates that gastrointestinal CMV infection should be considered in the differential diagnosis of severe chronic diarrhea in immunocompetent patients and that antiviral treatment may be justified in this setting.