ArticleInternal medicine (Tokyo, Japan)2025
Steroid-responsive Encephalopathy with a Primary CMV Infection Complicated by Enteritis in a Young Woman with Ulcerative Colitis.
Article in Internal medicine (Tokyo, Japan), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
A 23-year-old woman with ulcerative colitis (UC) presented with fever, headache, an altered mental status, and bloody stool. A neurological examination, magnetic resonance imaging, and electroencephalography revealed right-side dominant encephalopathy. Although a serological analysis revealed a primary cytomegalovirus (CMV) infection, the cerebrospinal fluid (CSF) showed no evidence of a viral load, although the CSF interleukin-6 levels were markedly elevated (1,670 pg/mL). Encephalopathy rapidly improved with steroid therapy; however, the presence of bloody stool persisted. A colon biopsy revealed concurrent CMV enteritis, which improved with ganciclovir. This case shows that steroid-responsive encephalopathy can occur during a primary CMV infection. Additionally, CMV enteritis complicated by a primary CMV infection should be considered in patients with UC.
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