{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:02:51Z","timestamp":1756339371750,"version":"3.44.0"},"reference-count":9,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2017,12,16]]},"abstract":"<jats:p>Cytomegalovirus (CMV) colitis usually occurs in patients with advanced immunosuppression when the CD4 count is &lt;50\u2009cells\/\u03bcL. We reported a case of recurrent CMV colitis in a patient with HIV who presented with profuse lower gastrointestinal bleed. This was a case of immune reconstitution inflammatory syndrome (IRIS) manifesting as CMV colitis and has been reported only once in the literature previously. This patient had a CD4 count of 157\u2009cells\/\u03bcL and undetectable viral load after being on antiretroviral therapy (ART) for 5 months, which was consistent with IRIS. The diagnosis of CMV was confirmed by a colonoscopy and a biopsy. This case highlights the fact that CMV colitis can manifest despite a moderately preserved CD4 count and the clinicians must have a high index suspicion for IRIS syndrome especially when someone was recently started on ART. Since effective treatment is available, it is important not to miss the diagnosis of CMV colitis.<\/jats:p>","DOI":"10.1136\/bcr-2017-221121","type":"journal-article","created":{"date-parts":[[2018,1,4]],"date-time":"2018-01-04T04:26:18Z","timestamp":1515039978000},"page":"bcr-2017-221121","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Recurrent cytomegalovirus colitis: a rare case of immune reconstitution inflammatory syndrome"],"prefix":"10.1136","volume":"2018","author":[{"given":"Joseph","family":"Alukal","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Mercy Fitzgerald Hospital, Darby, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammed","family":"Asif","sequence":"additional","affiliation":[{"name":"Department of Surgery, Mercy Fitzgerald Hospital, Darby, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachana","family":"Mundada","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Mercy Fitzgerald Hospital, Darby, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William B","family":"McNamee","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine-Infectious Disease, Mercy Fitzgerald Hospital, Darby, Pennsylvania, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,1,4]]},"reference":[{"key":"2025082700535164000_2018.jan03_3.bcr-2017-221121.1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkh396"},{"key":"2025082700535164000_2018.jan03_3.bcr-2017-221121.2","doi-asserted-by":"crossref","DOI":"10.1155\/2009\/984324","article-title":"Cytomegalovirus colitis in an HIV-positive woman with a relatively preserved CD4 count","volume":"20","author":"Johnstone","year":"2009","journal-title":"Can J Infect Dis Med Microbiol"},{"key":"2025082700535164000_2018.jan03_3.bcr-2017-221121.3","doi-asserted-by":"publisher","DOI":"10.1086\/499356"},{"key":"2025082700535164000_2018.jan03_3.bcr-2017-221121.4","unstructured":"Fauci AS , Lane HC . Chapter 182: human immunodeficiency virus disease: AIDS and related disorders. In: Fauci AS , Braunwald E , Kasper DL , Hauser SL , Longo DL . eds. Harrison\u2019s principles of internal medicine. 17th edn. New York: McGraw-Hill Companies, 2008."},{"key":"2025082700535164000_2018.jan03_3.bcr-2017-221121.5","doi-asserted-by":"publisher","DOI":"10.1086\/526783"},{"issue":"suppl 1","key":"2025082700535164000_2018.jan03_3.bcr-2017-221121.6","first-page":"s29","article-title":"Cytomegalovirus colitis in AIDS: presentation in 44 patients and a review of the literature","volume":"4","author":"Dieterich","year":"1991","journal-title":"J Acquir Immune Defic Syndr"},{"key":"2025082700535164000_2018.jan03_3.bcr-2017-221121.7","doi-asserted-by":"publisher","DOI":"10.1080\/00365549850161098"},{"key":"2025082700535164000_2018.jan03_3.bcr-2017-221121.8","doi-asserted-by":"crossref","unstructured":"Barling DR , Tucker S , Varia H , et al . Large bowel perforation secondary to CMV colitis: an unusual primary presentation of HIV infection. BMJ Case Rep 2016. doi: 10.1136\/bcr-2016-217221. [Epub ahead print 21 Dec 2016].doi:10.1136\/bcr-2016-217221","DOI":"10.1136\/bcr-2016-217221"},{"key":"2025082700535164000_2018.jan03_3.bcr-2017-221121.9","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1159\/000443198","article-title":"Cytomegalovirus colitis, cytomegalovirus hepatitis and systemic cytomegalovirus infection: common features and differences","volume":"1","author":"Nakase","year":"2016","journal-title":"Inflamm Intest Dis"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2017-221121","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:54:00Z","timestamp":1756281240000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2017-221121"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,1,4]]},"references-count":9,"alternative-id":["10.1136\/bcr-2017-221121"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2017-221121","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2018,1,4]]}}}