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Deprecated: Implicit conversion from float 243.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 BMJ+Case+Rep 2016 ; 2016 (ä): ä Nephropedia Template TP
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Perforation of the bowel due to cytomegalovirus infection in a man with AIDS: surgery is not always necessary! #MMPMID27440845
Yoganathan KT; Morgan AR; Yoganathan KG
BMJ Case Rep 2016[]; 2016 (ä): ä PMID27440845show ga
Cytomegalovirus (CMV) infection is the most common viral opportunistic infection in immunocompromised patients and is a rare cause of bowel perforation. It invariably requires surgical intervention and is often fatal. We report a 50-year-old Caucasian man with AIDS, presented 3?weeks after developing abdominal pain and distension. He was treated for CMV retinitis in the past. His adherence to antiretroviral therapy was poor. Examination revealed a recurrence of active CMV retinitis. His abdomen was tender and distended. The plain X-ray of the abdomen revealed a double wall sign (Rigler's sign), indicating pneumoperitoneum due to the bowel perforation. The upper endoscopy was normal. His CD4 count was 30?cells/mm3. He was treated with cidofovir infusion. He made a full recovery, without requiring any form of surgery. However, he died of adult respiratory distress syndrome 14?months later, due to iatrogenic acute pancreatitis.