Cytomegalovirus (CMV) is an important cause of opportunistic infection in immunocompromised patients. CMV infection occurs as a result of the cell-mediated immunity change in lymphoma patients. Although CMV can cause ulceration anywhere in the gastrointestinal (GI) tract in immunocompromised patients, only a few case reports about CMV GI infection in malignant lymphoma have been documented in literature. Furthermore, it was rare that CMV gastric ulcer with massive bleeding presented as an initial manifestation in a patient who has been not diagnosed lymphoma. We report a case of CMV induced gastric ulcer as an initial manifestation in patient with Hodgkin's disease.
Aged ; Cytomegalovirus ; Cytomegalovirus Infections/*diagnosis/pathology ; Diagnosis, Differential ; Gastroscopy ; Hodgkin Disease/complications/*diagnosis ; Humans ; Male ; Stomach Ulcer/*diagnosis/pathology/virology ; Tomography, X-Ray Computed

A 32-year-old man, who had no previous medical history, was hospitalized with 3-week duration of abdominal pain, fever, and watery diarrhea. Initial colonoscopy showed subepithelial hemorrhagic spots throughout the entire colon together with well-circumscribed ulcer around the ileocecal valve. Serologic test disclosed HIV-positive and repeated biopsies at ulcer base finally revealed that the patient had cytomegalovirus ulcer in ileocecal area.
AIDS-Related Opportunistic Infections/complications/*diagnosis ; Adult ; Colitis/complications/diagnosis/*virology ; Colonoscopy ; Cytomegalovirus Infections/complications/*diagnosis ; Humans ; Ileal Diseases/complications/pathology/*virology ; *Ileocecal Valve/pathology ; Male ; Ulcer/complications/pathology/*virology

Hepatitis A virus (HAV) infections occur predominantly in children, and are usually self-limiting. However, 75-95% of the infections in adults are symptomatic (mostly with jaundice), with the illness symptoms usually persisting for a few weeks. Atypical manifestations include relapsing hepatitis, prolonged cholestasis, and complications involving renal injury. Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is a severe, drug-induced hypersensitivity reaction characterized by skin rash, fever, lymph-node enlargement, and internal organ involvement. We describe a 22-year-old male who presented with acute kidney injury and was diagnosed with prolonged cholestatic hepatitis A. The patient also developed DRESS syndrome due to antibiotic and/or antiviral treatment. To our knowledge, this is the first report of histopathologically confirmed DRESS syndrome due to antibiotic and/or antiviral treatment following HAV infection with cholestatic features and renal injury.
Acute Kidney Injury/diagnosis ; Anti-Bacterial Agents/*adverse effects/therapeutic use ; Cefotaxime/adverse effects/therapeutic use ; Cholestasis/complications/*diagnosis ; Cytomegalovirus/genetics ; Cytomegalovirus Infections/drug therapy/virology ; DNA, Viral/analysis ; Eosinophilia/etiology ; Exanthema/*chemically induced/pathology ; Ganciclovir/therapeutic use ; Hepatitis A/complications/*diagnosis/drug therapy ; Humans ; Hydrocortisone/therapeutic use ; Immunoglobulins/therapeutic use ; Male ; Syndrome ; Young Adult

Gastrointestinal complications (GI) after thoracoabdominal aortic repair can be classified as biliary disease, heptic dysfunction, pancreatitis, GI bleeding, peptic ulcer disease, bowel ischemia, paralytic ileus, and aortoenteric fistula. Theses complications are associated with high post operative morbidity and mortality. Most of the aortoenteric fistulae after thoracoabdominal aortic surgery are found at the duodenum, near the surgical site. These rare complications are caused by an indirect communication with abdominal aorta that originated from an aneursymal formation ruptured into the duodenum. Such aorto-duodenal fistula formation is considered as a result of inflammatory change from secondary infection near the surgical instruments. Herein, we report two cases of massive upper GI bleeding from aorto-duodenal fistulae and spontaneous lower GI perforation related to cytomegalovirus infection after abdominal aortic aneurysmal repair operations.
Aged ; Aged, 80 and over ; Aorta, Abdominal/*surgery ; Aortic Aneurysm, Abdominal/complications/*surgery ; Aortic Diseases/*diagnosis/surgery/virology ; Cytomegalovirus Infections/*complications/diagnosis/pathology ; Endoscopy, Gastrointestinal ; Gastrointestinal Hemorrhage/etiology ; Humans ; Intestinal Fistula/*diagnosis/surgery/virology ; Intestinal Perforation/*diagnosis/virology ; Male ; Vascular Fistula/*diagnosis/surgery/virology

Gastrointestinal complications (GI) after thoracoabdominal aortic repair can be classified as biliary disease, heptic dysfunction, pancreatitis, GI bleeding, peptic ulcer disease, bowel ischemia, paralytic ileus, and aortoenteric fistula. Theses complications are associated with high post operative morbidity and mortality. Most of the aortoenteric fistulae after thoracoabdominal aortic surgery are found at the duodenum, near the surgical site. These rare complications are caused by an indirect communication with abdominal aorta that originated from an aneursymal formation ruptured into the duodenum. Such aorto-duodenal fistula formation is considered as a result of inflammatory change from secondary infection near the surgical instruments. Herein, we report two cases of massive upper GI bleeding from aorto-duodenal fistulae and spontaneous lower GI perforation related to cytomegalovirus infection after abdominal aortic aneurysmal repair operations.
Aged ; Aged, 80 and over ; Aorta, Abdominal/*surgery ; Aortic Aneurysm, Abdominal/complications/*surgery ; Aortic Diseases/*diagnosis/surgery/virology ; Cytomegalovirus Infections/*complications/diagnosis/pathology ; Endoscopy, Gastrointestinal ; Gastrointestinal Hemorrhage/etiology ; Humans ; Intestinal Fistula/*diagnosis/surgery/virology ; Intestinal Perforation/*diagnosis/virology ; Male ; Vascular Fistula/*diagnosis/surgery/virology