A Case of Cytomegalovirus Colitis Following Immunosuppressive Treatment for Pyoderma Gangrenosum

We report a case of pyoderma gangrenosum (PG) complicated by cytomegalovirus (CMV)‐induced colitis. A 79‐year‐old woman with PG was treated with corticosteroid and cyclosporin. She had blood in her stool and advancing anemia during the treatment. A colonoscopic biopsy specimen from the colon revealed typical CMV‐infected cells with CMV inclusions confirmed by immunohistochemistry. Furthermore, there were many CMV‐antigen‐positive leukocytes, suggesting an active CMV infection, which is serious in compromised hosts. Although ulcerative colitis and Crohn's disease are well known as complications of PG, CMV enterocolitis should be considered in the differential diagnosis of enterocolitis in immunocompromised patients.

[1]  M. Suga,et al.  Systemic lupus erythematosus complicated by cytomegalovirus-induced hemophagocytic syndrome and colitis. , 2002, Internal medicine.

[2]  M. Mokni,et al.  Pyoderma gangrenosum: a report of 21 cases , 2002, International journal of dermatology.

[3]  H. Hashimoto,et al.  Cytomegalovirus infection in patients with systemic lupus erythematosus. , 2002, Clinical and experimental rheumatology.

[4]  S. Jabłońska,et al.  Superficial Granulomatous Pyoderma gangrenosum of the Face, Successfully Treated by Ciclosporine: A Long-Term Follow-Up , 2001, Dermatology.

[5]  S. Kano,et al.  [Three patients with systemic lupus erythematosus complicated by cytomegalovirus colitis]. , 2000, Nihon Rinsho Men'eki Gakkai kaishi = Japanese journal of clinical immunology.

[6]  J. Callen,et al.  Peripheral ulcerative keratitis--an extracutaneous neutrophilic disorder: report of a patient with rheumatoid arthritis, pustular vasculitis, pyoderma gangrenosum, and Sweet's syndrome with an excellent response to cyclosporine therapy. , 1999, Journal of the American Academy of Dermatology.

[7]  J. Callen,et al.  Chlorambucil is an effective corticosteroid-sparing agent for recalcitrant pyoderma gangrenosum. , 1996, Journal of the American Academy of Dermatology.

[8]  V. Ho,et al.  Treatment of pyoderma gangrenosum. , 1996, Journal of the American Academy of Dermatology.

[9]  C. Samlaska,et al.  Pyoderma gangrenosum and cranial osteolysis: case report and review of the paediatric literature , 1995, The British journal of dermatology.

[10]  R. Goodgame.  Gastrointestinal Cytomegalovirus Disease , 1993, Annals of Internal Medicine.

[11]  C. Griffiths,et al.  Treatment of pyoderma gangrenosum with cyclosporine. , 1992, Archives of dermatology.

[12]  P. Pigatto,et al.  Effectiveness of cyclosporine treatment in severe psoriasis: a clinical and immunologic study. , 1989, Journal of the American Academy of Dermatology.

[13]  M. Kumar,et al.  Diseases produced by cytomegaloviruses. , 1978, The Medical clinics of North America.

[14]  R. Betts,et al.  Cytomegalovirus (CMV) in the compromised host(s). , 1977, Annual review of medicine.