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a, b: Colonoscopy showing mucosal ulcerations and extensive inflammation through the colon. Lesions were biopsied and pathology/staining indicated CMV colitis.
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CMV quantitative PCR was highly elevated (55,937 IU/mL) indicating viremia and the patient was started on intravenous ganciclovir. Colonoscopy yielded multiple raised plaques within the terminal ileum and pan-colonic ulcerations that were biopsied and clipped (Fig. 1a, b).
a, b: Pathology obtained from colonic biopsies showing atypical nuclei and "owl's eye" inclusion bodies consistent with cytomegalovirus (CMV) infection.
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The obtained pathology showed focal glandular atypia, pseudostratification of enlarged nuclei, and inclusion bodies with positive immunohistochemical staining for CMV (Fig. 2a, b).