Radiation Proctitis with Recurrent Gastrointestinal Bleeding Complicated by Cytomegalovirus

Division

North Florida

Hospital

North Florida Regional Medical Center

Document Type

Case Report

Publication Date

10-31-2023

Keywords

radiation proctitis, cytomegalovirus, haematochezia, immunocompetent, recurrent gastrointestinal bleeding

Disciplines

Digestive System Diseases | Infectious Disease | Internal Medicine | Medicine and Health Sciences | Virus Diseases

Abstract

Cytomegalovirus (CMV) usually causes infections with mild symptoms in immunocompetent individuals. However, in immunocompromised patients, these infections can be serious or life-threatening. Following initial infection, CMV typically becomes dormant but remains lifelong in the host. Reactivation of the latent virus can occur in many organ systems, including the gastrointestinal (GI) tract. Radiation proctitis is a known risk factor associated with prostate radiation, with complicating ulceration and GI bleeding. We present the first case report of an immunocompetent 81-year-old male with multiple episodes of life-threatening GI bleeding, secondary to a non-healing CMV-positive rectal ulcer and CMV colitis following radiation for prostate cancer. Multiple insults including prostate radiation, repeated blood transfusions and CMV infection likely contributed to the recurrent bleeding episodes.

Publisher or Conference

Journal of the Royal College of Physicians of Edinburgh

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