Small bowel perforation due to cytomegalovirus infection in a patient with AIDS
Abstract
Cytomegalovirus (CMV) can cause disseminated or localized disease in people living with human immunodeficiency virus (HIV) with advanced immunosuppression, usually those with CD4+ T-lymphocyte (CD4) cell counts <50 cells/mm3 who do not receive, complies, or does not respond to antiretroviral therapy (ART). This article reports the case of a patient living with HIV without ART who was admitted to the emergency department for abdominal pain. During laparotomy, perforation of the ileum was found, requiring right hemicolectomy, ileotransverse anastomosis, and drainage due to fecaloid peritonitis. The report of histopathology documents multiple cytomegalic inclusions in stromal, epithelial, and endothelial cells, predominantly in the ileum, at the level of the perforation area. Although CMV disease in the gastrointestinal tract is one of the most common complications of human immunodeficiency syndrome (AIDS), ileal perforation is an unusual manifestation with high mortality.
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