CMV gastroenteritis/colitis
Alternative names:
colitis - cytomegalovirus; gastroenteritis - cytomegalovirus;
esophagitis - cytomegalovirus; gastrointestinal CMV disease
Treatment:
The objectives of therapy are to control the infection and
relieve symptoms. Treatment in the form of antiviral medications
helps stop the replication of the virus, but does not destroy
the virus. Antiviral medications that may be used include
ganciclovir (Cytovene®) or foscarnet (Foscavirâ®).
Treatment is given intravenously for several weeks, and in
some, therapy may be prolonged. CMV hyperimmune globulin may
be used in cases of severe refractory infection. Antidiarrheal
medications and analgesics
are used for the relief of symptoms.
Nutritional supplements or intravenous
nutrition to combat wasting
may be indicated.
Expectations (prognosis):
Individuals with normal immune systems typically have a
self-limited infection, with resolution of symptoms without
treatment. Those who have suppressed immune systems have more
severe symptoms due to the infection. The outcome depends
upon the severity of the immunodeficiency and the severity
of the infection. People with AIDS may have a worse outcome
than those with a different immunodeficiency. CMV infection
typically is a systemic disease, even if patients only have
GI symptoms. Therefore, overall outcome depends on the response
to systemic therapy with antiviral drugs.
Complications:
Antiviral medications stop the replication of the virus,
but do not destroy the virus. CMV is in itself immunosuppressive
and may worsen the manifestations of other causes of immunosuppression.
Low white blood cell count
may occur with use of cytovene. Kidney impairment may occur
with the use of foscarnet.
Calling your health care provider:
Call for an appointment with your health care provider if
symptoms develop that are suggestive of CMV gastroenteritis.
Update Date: 05/08/00
Ronald J. Lew, MD Hospital of the University of Pennsylvania
Division, Gastroenterology - Fellow
VeriMed Healthcare Network
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