Severe ischemic cytomegalovirus proctocolitis with multipleperforation

AbstractCytomegalovirus (CMV) typically causes gastrointestinal infections in immunocompetent patients. Colonic perforationssecondary to CMV are exceeding rare. We describe a 88-year-old male presenting with a week-long history of intractableabdominal discomfort, bloating, nausea and diarrhea. Flexible sigmoidoscopy revealed significant ulceration with yellowishslough. Emergency surgery was performed subsequently in view of multiple perforations in the rectosigmoid junction. CMVgastrointestinal infections demonstrated an ischemic process secondary to vasculitis, which accelerated the pathway to colonicperforation. CMV gastrointestinal infection should be considered as a differential diagnosis in patients with colonoscopyfindings similar to ischemic colitis and Clostridium difficile infections