Locations Main Campus: Chesterfield, MO 63017   |   Locations
314-434-1500 314-434-1500   |   Contact Us

Multimedia Encyclopedia

BACK
TO
TOP
 
E-mail Form
Email Results

 
 
Print-Friendly
Bookmarks
bookmarks-menu

CMV - gastroenteritis/colitis

Colitis - cytomegalovirus; Gastroenteritis - cytomegalovirus; Gastrointestinal CMV disease

 

CMV gastroenteritis/colitis is inflammation of the stomach or intestine due to infection with cytomegalovirus (CMV).

This same virus can also cause:

  • Lung infection
  • Infection at the back of the eye
  • Infections of a baby while still in the womb

Causes

 

Cytomegalovirus (CMV) is a herpes-type virus. It is related to the virus that causes chickenpox.

Infection with CMV is very common. It is spread by saliva, urine, respiratory droplets, sexual contact, and blood transfusions. Most people are exposed at some point, but most of the time, the virus produces mild or no symptoms in healthy people.

Serious CMV infections can occur in people with weakened immune systems due to:

  • AIDS
  • Chemotherapy treatment for cancer
  • During or after bone marrow or organ transplant
  • Ulcerative colitis or Crohn disease

Rarely, serious CMV infection involving the GI tract has occurred in people with a healthy immune system.

 

Symptoms

 

Gastrointestinal CMV disease may affect one area or the entire body. Ulcers can occur in the esophagus, stomach, small intestine, or colon. These ulcers are associated with symptoms such as:

  • Abdominal pain
  • Difficulty swallowing or pain with swallowing
  • Nausea
  • Vomiting

When the intestines are involved, the ulcers may cause:

  • Abdominal pain
  • Bloody stools
  • Diarrhea
  • Fever
  • Weight loss

More severe infections can result in gastrointestinal bleeding or a hole through the wall of the bowel.

 

Exams and Tests

 

Tests that may be done include:

  • Barium enema
  • Colonoscopy
  • Upper endoscopy (EGD)
  • Stool culture to rule out other causes of infection
  • Upper GI and small bowel series

Laboratory tests will be done on a sample of tissue taken from your stomach or intestine. The tests, such as a gastric or intestinal tissue culture or biopsy, determine if the virus is in the tissue.

A CMV serology test is done to look for antibodies to the CMV virus in your blood.

Another blood test that looks for the presence and number of virus particles in the blood can also be done.

 

Treatment

 

Treatment is meant to control the infection and relieve symptoms.

Medicines to fight the virus (antiviral medicines) are prescribed. The medicines may be given through a vein (IV), and sometimes by mouth, for several weeks. The most commonly used medicines are ganciclovir and valganciclovir.

In some cases, long-term therapy may be needed. A medicine called CMV hyperimmune globulin may be used when other drugs don't work.

Other medicines may include:

  • Drugs to prevent or reduce diarrhea
  • Painkillers (analgesics)

Nutritional supplements or nutrition given through a vein (IV) may be used to treat muscle loss due to the disease.

 

Outlook (Prognosis)

 

In people with a healthy immune system, symptoms go away without treatment in most cases.

Symptoms are more severe in those with a weakened immune system. The outcome depends on how severe the immune system deficiency and the CMV infection are.

People with AIDS may have a worse outcome than those with a weakened immune system due to another reason.

CMV infection typically affects the entire body, even if only gastrointestinal symptoms are present. How well a person does depends on how well the antiviral drugs work.

 

Possible Complications

 

The drugs used to fight the virus may cause side effects. The type of side effect depends on the specific drug used. For example, the drug ganciclovir may lower your white blood cell count. Another drug, foscarnet, may lead to kidney problems.

 

When to Contact a Medical Professional

 

Call your health care provider if you have symptoms of CMV gastroenteritis/colitis.

 

Prevention

 

There is a high risk of CMV infection in people who receive an organ transplant from a CMV-positive donor. Taking the antiviral drugs ganciclovir (Cytovene) and valganciclovir (Valcyte) by mouth before the transplant can lower your chance of getting a new infection or reactivating an old infection.

People with AIDS who are effectively treated with highly active antiretroviral therapy are much less likely to get a CMV infection.

 

 

Open References

References

Crumpacker CS. Cytomegalovirus. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 140.

Majhail NS, Weisdorf DJ. Gastrointestinal and hepatic complications of solid organ and hematopoietic cell transplantation. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 110.

Wilcox GM. Gastrointestinal consequences of infection with human immunodeficiency virus. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease . 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 34.

 
  • Gastrointestinal anatomy

    Gastrointestinal anatomy - illustration

    The gastrointestinal system is comprised of the stomach, and the small and large intestines.

    Gastrointestinal anatomy

    illustration

  • Stomach and stomach lining

    Stomach and stomach lining - illustration

    The stomach connects the esophagus to the small intestines and is where the majority of food digestion takes place.

    Stomach and stomach lining

    illustration

  • CMV (cytomegalovirus)

    CMV (cytomegalovirus) - illustration

    Cytomegalovirus is a large herpes-type virus commonly found in humans that can cause serious infections in people with impaired immunity. The infection may result in pneumonia, gastroenteritis, retinitis or encephalitis. Antiviral medicines may stop the replication of the virus, but will not destroy it.

    CMV (cytomegalovirus)

    illustration

    • Gastrointestinal anatomy

      Gastrointestinal anatomy - illustration

      The gastrointestinal system is comprised of the stomach, and the small and large intestines.

      Gastrointestinal anatomy

      illustration

    • Stomach and stomach lining

      Stomach and stomach lining - illustration

      The stomach connects the esophagus to the small intestines and is where the majority of food digestion takes place.

      Stomach and stomach lining

      illustration

    • CMV (cytomegalovirus)

      CMV (cytomegalovirus) - illustration

      Cytomegalovirus is a large herpes-type virus commonly found in humans that can cause serious infections in people with impaired immunity. The infection may result in pneumonia, gastroenteritis, retinitis or encephalitis. Antiviral medicines may stop the replication of the virus, but will not destroy it.

      CMV (cytomegalovirus)

      illustration

    Tests for CMV - gastroenteritis/colitis

     
       

      Review Date: 5/11/2016

      Reviewed By: Subodh K. Lal, MD, gastroenterologist with Gastrointestinal Specialists of Georgia, Austell, GA. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

       
       
       

       

       

      A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.



      Content is best viewed in IE9 or above, Firefox and Google Chrome browser.