Document Detail


Cytomegalovirus pseudotumor of the duodenum in a patient with AIDS: an unrecognized and potentially treatable clinical entity.
MedLine Citation:
PMID:  19695917     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cytomegalovirus (CMV) is a common pathogen affecting the gastrointestinal tract in patients with AIDS. We report a case of CMV-induced pseudotumor of the duodenum in a patient with AIDS and review other reported cases of CMV-induced pseudotumors in the gastrointestinal tract. CMV-induced pseudotumor in patients with AIDS is an exceptionally rare clinical entity, and to our knowledge no reports have previously summarized this clinical entity. METHODS: All previous cases included in our literature review were found using a PubMed search (1980-November 2008) of the English-language medical literature applying the terms 'CMV infection', 'inflammatory mass', 'pseudotumor', and 'gastrointestinal tract'. The references cited in these articles were examined to identify additional reports. RESULTS: Although CMV-induced duodenitis has been described in patients with HIV infection, to our knowledge CMV-induced pseudotumor of the duodenum has not been previously reported in the literature. We describe the first case of an AIDS patient with CMV pseudotumor responding to oral treatment with valganciclovir with complete resolution of the CMV mass. Among reports of non-duodenal pseudotumor reported in the English literature, we found only 14 cases of CMV-induced gastrointestinal pseudotumors in HIV-positive patients. The clinical manifestations, pathologic findings of the CMV pseudotumors, as well as the treatment and outcome of these HIV patients are reviewed. CONCLUSION: CMV pseudotumor should be included in the differential diagnosis of gastrointestinal mass lesions in AIDS patients and in other immunocompromised patients. The tumor often responds to antiviral therapy, but resolution of a CMV mass as a result of oral antiviral therapy has not been previously described. Since pseudotumors secondary to CMV often respond to medical treatment, it is important that the physicians treating severely immunocompromised patients are aware of this entity.
Authors:
Theodoros Kelesidis; Shirly Tozzi; Roger Mitty; Michael Worthington; Jorge Fleisher
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Publication Detail:
Type:  Case Reports; Journal Article; Review     Date:  2009-08-19
Journal Detail:
Title:  International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases     Volume:  14     ISSN:  1878-3511     ISO Abbreviation:  Int. J. Infect. Dis.     Publication Date:  2010 Apr 
Date Detail:
Created Date:  2010-03-24     Completed Date:  2010-06-28     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9610933     Medline TA:  Int J Infect Dis     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  e274-82     Citation Subset:  IM    
Affiliation:
Division of Infectious Diseases, Department of Medicine, Caritas St. Elizabeth's Medical Center, Tufts University School of Medicine, Boston, MA 02135, USA. Theodoros.Kelesidis@caritaschristi.org
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MeSH Terms
Descriptor/Qualifier:
AIDS-Related Opportunistic Infections / drug therapy,  virology*
Antiviral Agents / therapeutic use
Cytomegalovirus*
Cytomegalovirus Infections / drug therapy,  immunology,  virology*
Duodenal Diseases / drug therapy,  immunology,  virology*
Ganciclovir / analogs & derivatives,  therapeutic use
HIV*
HIV Infections / immunology,  virology*
Humans
Male
Middle Aged
Chemical
Reg. No./Substance:
0/Antiviral Agents; 0/valganciclovir; 82410-32-0/Ganciclovir

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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