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Cytomegalovirus colitis in an immunocompetent old woman successfully treated with ganciclovir: a case report.

Cytomegalovirus (CMV) diseases occur almost exclusively in the immunocompromised hosts. Persons most commonly affected are patients with acquired immunodeficiency syndrome (AIDS). On rare occasions, however, CMV diseases can be seen in apparently immunocompetent persons. A CMV colitis in a 68-year old immunocompetent woman presenting with watery diarrhea, malaise, and body weight loss of about 5 kg over a three week period is reported. Colonoscopy and mucosal biopsy revealed CMV colitis involving the sigmoid colon. Treatment for two weeks with ganciclovir (10 gm/kg/day I.V. in 2 divided doses) resulted in resolution of colitis and clinical symptoms without any noticeable side-effects. There was no relapse of infection by six months of follow-up. The possibility of CMV colitis should be considered in any elderly person with watery diarrhea, general debilitation, marked body weight loss and with negative stool cultures. CMV colitis may be more frequent than is usually believed. It has a favorable response to ganciclovir without further relapse after the successful treatment in patients with normal immune function.