| Theme |
Cytomegalovirus enterocolitis and Clostridium difficile infection |
| Title |
Treatment of cytomegalovirus colitis complicating inflammatory bowel disease : From the opinion that there is no need for aggressive treatment |
| Author |
Katsuyoshi Matsuoka |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| Author |
Mamoru Watanabe |
Department of Gastroenterology and Hepatology, Tokyo Medical and Dental University |
| [ Summary ] |
Ulcerative colitis can be complicated by cytomegalovirus (CMV) colitis, which may further contribute to resistance to medical treatment of ulcerative colitis. CMV infection and CMV disease should clearly be distinguished ; however, this is often difficult in patients with ulcerative colitis because they already have bowel damage and symptoms. At present, CMV immunohistochemistry and mucosal CMV polymerase chain reaction assay are reported to be the most specific tests for the diagnosis of CMV colitis complicating ulcerative colitis, although evidence is not sufficient. As intestinal infl ammation and immunosuppression can cause CMV reactivation, controlling inflammation can suppress CMV reactivation. Therefore, primary therapeutic strategy should be to control the intestinal inflammation of ulcerative colitis and the indication of anti-CMV drug should be carefully considered. |