DOI: 10.12890/2020_001911

COVID-19 and Cytomegalovirus Co-infection: A Challenging Case of a Critically Ill Patient with Gastrointestinal Symptoms

Authors

  • Pedro HF Amaral Gastrointestinal Surgery Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Bernadete MC Ferreira Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Sergio Roll Gastrointestinal Surgery Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Precil DMM Neves Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Luca GA Pivetta Gastrointestinal Surgery Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Sara Mohrbacher Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Eduardo RM Dias Gastrointestinal Surgery Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Victor AH Sato Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Érico S Oliveira Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Leonardo VB Pereira Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Alessandra M Bales Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Luciana L Nardotto Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Jéssica N Ferreira Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Américo L Cuvello-Neto Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil
  • Pedro R Chocair Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil

drpedroamaral@gmail.com

Keywords

Colitis, COVID-19, cytomegalovirus, immunosuppression, intensive care unit

Abstract

COVID-19 is a severe disease that has reached pandemic status. To the best of our knowledge, we describe the first case of COVID-19 and cytomegalovirus (CMV) co-infection in a critically ill patient. We discuss the challenge of establishing the diagnosis as well as the management of tissue-invasive gastrointestinal CMV infection (TI-GI CMV) simulating vascular involvement and intestinal obstruction in a critically ill patient.

View the entire article

Downloads

References

  1. WHO. Coronavirus disease 2019 (COVID-19) Situation Report – 94. https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200423-sitrep-94-covid-19.pdf?sfvrsn=b8304bf0_4 (accessed 1 Aug 2020).
  2. Health Ministry, Brazilian Government. COVID19 Painel Coronavirus. https://covid.saude.gov.br (accessed 9 July 2020).
  3. Huang C, Wang Y, Li X, Ren L, Zhao J, Hu Y, et al. Clinical features of patients infected with 2019 novel coronavirus in Wuhan, China. Lancet 2020;395(10223):497–506.
  4. Patra S, Samal SC, Chacko A, Mathan VI, Mathan MM. Cytomegalovirus infection of the human gastrointestinal tract. J Gastroenterol Hepatol 1999;14(10):973–976.
  5. Fakhreddine AY, Frenette CT, Konijeti GG. A practical review of cytomegalovirus in gastroenterology and hepatology. Gastroenterol Res Pract 2019;2019:6156581.
  6. Chen N, Zhou M, Dong X, Qu J, Gong F, Han Y, et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: a descriptive study. Lancet 2020;395(10223):507–513.
  7. Cheung KS, Hung IF, Chan PP, Lung KC, Tso E, Liu R, et al. Gastrointestinal manifestations of SARS-CoV-2 infection and virus load in fecal samples from a Hong Kong cohort: systematic review and meta-analysis. Gastroenterology 2020;159(1):85–95.
  8. Gu J, Han B, Wang J. COVID-19: gastrointestinal manifestations and potential fecal-oral transmission. Gastroenterology 2020;158(6):1518–1519.
  9. Han C, Duan C, Zhang S. Digestive symptoms in COVID-19 patients with mild disease severity: clinical presentation, stool viral RNA testing and outcomes. Am J Gastroenterol 2020;115(6):916–923.
  10. Bhayana R, Som A, Li ML. Abdominal imaging findings in COVID-19: preliminary observations. Radiology 2020 May 11. doi: 10.1148/radiol. 201908 [Epub ahead of print].
  11. D'Ardes D, Boccatonda A, Schiavone C, Santilli F, Guagnano MT, Bucci M, et al. A case of coinfection with SARS-CoV-2 and cytomegalovirus in the era of COVID-19. Eur J Case Rep Intern Med 2020;7(5):001652.
  12. Osawa R, Singh N. Cytomegalovirus infection in critically ill patients: a systematic review. Crit Care 2009;13(3):R68.
  13. Moss P. "The ancient and the new": is there an interaction between cytomegalovirus and SARS-CoV-2 infection? Immun Ageing 2020;17:14.

Published

2020-09-02

Issue

Vol. 7 No. 10 (2020)

Categories

How to Cite

1.
Amaral P, Ferreira B, Roll S, Neves P, pivetta luca, Mohrbacher S, et al. COVID-19 and Cytomegalovirus Co-infection: A Challenging Case of a Critically Ill Patient with Gastrointestinal Symptoms. EJCRIM [Internet]. 2020 Sep. 2 [cited 2026 Nov. 4];7(10). Available from: https://ejcrim.com/index.php/ejcrim/article/view/1911