A case of severe ulcerative colitis diagnosed by outbreak of cytomegalovirus enteritis

A 51-year-old man was admitted to our hospital because of fever, stomachache, and bloody diarrhea. The symptoms and colonoscopy alluded severe ulcerative colitis (UC) , but the biopsy result of the colonoscopy suggested cytomegalovirus (CMV) enteritis. The patient was treated according to severe UC and CMV enteritis diagnosis ; therefore fluid replacement, mesalazine, and ganciclovir were administered. As his health improved, he was discharged ; however, he was admitted again because the symptoms reappeared. Our diagnosis, confirmed by a colon biopsy, was severe UC once more. After ratifying that there was no active infection of CMV, we started a treatment with steroid infusion. Then, his condition has improved. As in this case, it is rare that patients with no underlying disease or immune compromised state will develop CMV enteritis. But, if severe UC is suspected and an active infection of CMV resulted negetive, it may be desirable to start steroid therapy quickly without waiting for the biopsy result.