Colon perforation with peritonitis in an acquired immunodeficiency syndrome patient due to cytomegalovirus and amoebic colitis

Hung Chin Tsai, Susan Shin Jung Lee, Shue Ren Wann, Yao Shen Chen, Eng Rin Chen, Chuan Min Yen, Yung Ching Liu

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Invasive amoebiasis is rarely seen in human immunodeficiency virus (HIV)-infected individuals, even in endemic areas. By contrast, cytomegalovirus (CMV) disease is recognized as a major clinical problem in acquired immunodeficiency syndrome patients. A 34-year-old HIV-infected man with amoeba colitis, disseminated Mycobacterium avian complex and CMV infection with cecum perforation, presented with the initial symptoms of fever, shortness of breath and painful sensation when swallowing. He was treated with fluconazole, trimethoprim-sulfamethoxazole and hydrocortisone under the impression of esophageal candidiasis and Pneumocystis jiroveci pneumonia. However, diarrhea and abdominal pain developed on day 6 of hospitalization. Invasive amoebiasis and CMV colitis was diagnosed after examination of colon pathological specimens. Emergent laparotomy was performed. Right hemicolectomy with double barrel ileostomy and colostomy was done due to perforation of the cecum. Iodoquinol was given, followed by metronidazole 14 days afterwards. He underwent closure of double barrel ileostomy and colostomy 5 months later. This case illustrates the diagnostic challenge of caring for acquired immunodeficiency syndrome persons with multiple illnesses and medication use. CMV infection, amoebic colitis and possibly corticosteroid may have played a role in colon perforation in our patient.

Original languageEnglish
Pages (from-to)839-842
Number of pages4
JournalJournal of the Formosan Medical Association = Taiwan yi zhi
Volume104
Issue number11
Publication statusPublished - 2005
Externally publishedYes

Fingerprint

Amoebic Dysentery
Amebiasis
Ileostomy
Colostomy
Cecum
Cytomegalovirus Infections
Colitis
Peritonitis
Cytomegalovirus
Iodoquinol
Colon
Acquired Immunodeficiency Syndrome
HIV
Pneumocystis carinii
Amoeba
Pneumocystis Pneumonia
Fluconazole
Candidiasis
Metronidazole
Sulfamethoxazole Drug Combination Trimethoprim

Keywords

  • Acquired immunodeficiency syndrome
  • Amebiasis
  • Colitis
  • Cytomegalovirus infections
  • Glucocorticoids

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Colon perforation with peritonitis in an acquired immunodeficiency syndrome patient due to cytomegalovirus and amoebic colitis. / Tsai, Hung Chin; Lee, Susan Shin Jung; Wann, Shue Ren; Chen, Yao Shen; Chen, Eng Rin; Yen, Chuan Min; Liu, Yung Ching.

In: Journal of the Formosan Medical Association = Taiwan yi zhi, Vol. 104, No. 11, 2005, p. 839-842.

Research output: Contribution to journalArticle

Tsai, Hung Chin ; Lee, Susan Shin Jung ; Wann, Shue Ren ; Chen, Yao Shen ; Chen, Eng Rin ; Yen, Chuan Min ; Liu, Yung Ching. / Colon perforation with peritonitis in an acquired immunodeficiency syndrome patient due to cytomegalovirus and amoebic colitis. In: Journal of the Formosan Medical Association = Taiwan yi zhi. 2005 ; Vol. 104, No. 11. pp. 839-842.
@article{ac546a137e58451c854d41f6b1becc90,
title = "Colon perforation with peritonitis in an acquired immunodeficiency syndrome patient due to cytomegalovirus and amoebic colitis",
abstract = "Invasive amoebiasis is rarely seen in human immunodeficiency virus (HIV)-infected individuals, even in endemic areas. By contrast, cytomegalovirus (CMV) disease is recognized as a major clinical problem in acquired immunodeficiency syndrome patients. A 34-year-old HIV-infected man with amoeba colitis, disseminated Mycobacterium avian complex and CMV infection with cecum perforation, presented with the initial symptoms of fever, shortness of breath and painful sensation when swallowing. He was treated with fluconazole, trimethoprim-sulfamethoxazole and hydrocortisone under the impression of esophageal candidiasis and Pneumocystis jiroveci pneumonia. However, diarrhea and abdominal pain developed on day 6 of hospitalization. Invasive amoebiasis and CMV colitis was diagnosed after examination of colon pathological specimens. Emergent laparotomy was performed. Right hemicolectomy with double barrel ileostomy and colostomy was done due to perforation of the cecum. Iodoquinol was given, followed by metronidazole 14 days afterwards. He underwent closure of double barrel ileostomy and colostomy 5 months later. This case illustrates the diagnostic challenge of caring for acquired immunodeficiency syndrome persons with multiple illnesses and medication use. CMV infection, amoebic colitis and possibly corticosteroid may have played a role in colon perforation in our patient.",
keywords = "Acquired immunodeficiency syndrome, Amebiasis, Colitis, Cytomegalovirus infections, Glucocorticoids",
author = "Tsai, {Hung Chin} and Lee, {Susan Shin Jung} and Wann, {Shue Ren} and Chen, {Yao Shen} and Chen, {Eng Rin} and Yen, {Chuan Min} and Liu, {Yung Ching}",
year = "2005",
language = "English",
volume = "104",
pages = "839--842",
journal = "Journal of the Formosan Medical Association",
issn = "0929-6646",
publisher = "Elsevier Science Publishers B.V.",
number = "11",

}

TY - JOUR

T1 - Colon perforation with peritonitis in an acquired immunodeficiency syndrome patient due to cytomegalovirus and amoebic colitis

AU - Tsai, Hung Chin

AU - Lee, Susan Shin Jung

AU - Wann, Shue Ren

AU - Chen, Yao Shen

AU - Chen, Eng Rin

AU - Yen, Chuan Min

AU - Liu, Yung Ching

PY - 2005

Y1 - 2005

N2 - Invasive amoebiasis is rarely seen in human immunodeficiency virus (HIV)-infected individuals, even in endemic areas. By contrast, cytomegalovirus (CMV) disease is recognized as a major clinical problem in acquired immunodeficiency syndrome patients. A 34-year-old HIV-infected man with amoeba colitis, disseminated Mycobacterium avian complex and CMV infection with cecum perforation, presented with the initial symptoms of fever, shortness of breath and painful sensation when swallowing. He was treated with fluconazole, trimethoprim-sulfamethoxazole and hydrocortisone under the impression of esophageal candidiasis and Pneumocystis jiroveci pneumonia. However, diarrhea and abdominal pain developed on day 6 of hospitalization. Invasive amoebiasis and CMV colitis was diagnosed after examination of colon pathological specimens. Emergent laparotomy was performed. Right hemicolectomy with double barrel ileostomy and colostomy was done due to perforation of the cecum. Iodoquinol was given, followed by metronidazole 14 days afterwards. He underwent closure of double barrel ileostomy and colostomy 5 months later. This case illustrates the diagnostic challenge of caring for acquired immunodeficiency syndrome persons with multiple illnesses and medication use. CMV infection, amoebic colitis and possibly corticosteroid may have played a role in colon perforation in our patient.

AB - Invasive amoebiasis is rarely seen in human immunodeficiency virus (HIV)-infected individuals, even in endemic areas. By contrast, cytomegalovirus (CMV) disease is recognized as a major clinical problem in acquired immunodeficiency syndrome patients. A 34-year-old HIV-infected man with amoeba colitis, disseminated Mycobacterium avian complex and CMV infection with cecum perforation, presented with the initial symptoms of fever, shortness of breath and painful sensation when swallowing. He was treated with fluconazole, trimethoprim-sulfamethoxazole and hydrocortisone under the impression of esophageal candidiasis and Pneumocystis jiroveci pneumonia. However, diarrhea and abdominal pain developed on day 6 of hospitalization. Invasive amoebiasis and CMV colitis was diagnosed after examination of colon pathological specimens. Emergent laparotomy was performed. Right hemicolectomy with double barrel ileostomy and colostomy was done due to perforation of the cecum. Iodoquinol was given, followed by metronidazole 14 days afterwards. He underwent closure of double barrel ileostomy and colostomy 5 months later. This case illustrates the diagnostic challenge of caring for acquired immunodeficiency syndrome persons with multiple illnesses and medication use. CMV infection, amoebic colitis and possibly corticosteroid may have played a role in colon perforation in our patient.

KW - Acquired immunodeficiency syndrome

KW - Amebiasis

KW - Colitis

KW - Cytomegalovirus infections

KW - Glucocorticoids

UR - http://www.scopus.com/inward/record.url?scp=33645315556&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=33645315556&partnerID=8YFLogxK

M3 - Article

C2 - 16496064

AN - SCOPUS:33645315556

VL - 104

SP - 839

EP - 842

JO - Journal of the Formosan Medical Association

JF - Journal of the Formosan Medical Association

SN - 0929-6646

IS - 11

ER -