{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:40:01Z","timestamp":1756377601170,"version":"3.44.0"},"reference-count":16,"publisher":"BMJ","issue":"2","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2018,12,9]]},"published-print":{"date-parts":[[2019,2]]},"abstract":"<jats:p>A 42-year-old woman with a history of cholangiocarcinoma on adjuvant chemotherapy with capecitabine presented with painless haematochezia. She was found to have an isolated twenty-five mm ulcer in the ascending colon. Biopsies of the ulceration demonstrated typical cytomegalovirus (CMV) inclusions and her peripheral blood CMV PCR was significantly elevated. This is an unusual case of a solitary proximal colon ulcer. Non-steroidal anti-inflammatory drugs, inflammatory bowel disease and malignancy, are the most frequent causes of isolated ulcers in the proximal colon. Gastrointestinal (GI) CMV disease most commonly causes CMV colitis and is considered rare outside of the transplant population and other severely immunosuppressed patient groups. Patients who have received chemotherapy may also be at risk for GI CMV disease. The diagnosis should be suspected in patients who present with haematochezia or watery diarrhoea within a broad window of time after receiving chemotherapy.<\/jats:p>","DOI":"10.1136\/bcr-2018-226355","type":"journal-article","created":{"date-parts":[[2019,2,9]],"date-time":"2019-02-09T09:55:10Z","timestamp":1549706110000},"page":"bcr-2018-226355","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Solitary ascending colon ulcer diagnosed as gastrointestinal CMV disease"],"prefix":"10.1136","volume":"12","author":[{"given":"Robert","family":"Case Jr","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, University of Florida, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Stoner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, University of Florida College of Medicine, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Myrick","sequence":"additional","affiliation":[{"name":"Florida Cancer Affiliates Ocala, Ocala, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ellen","family":"Zimmermann","sequence":"additional","affiliation":[{"name":"Gastroenterology, University of Florida College of Medicine, Gainesville, Florida, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,2,9]]},"reference":[{"key":"2025082803043120000_12.2.bcr-2018-226355.1","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1016\/j.suc.2013.10.005","article-title":"Lower gastrointestinal bleeding","volume":"94","author":"Feinman","year":"2014","journal-title":"Surg Clin North Am"},{"key":"2025082803043120000_12.2.bcr-2018-226355.2","doi-asserted-by":"publisher","DOI":"10.1007\/s11894-013-0333-5"},{"key":"2025082803043120000_12.2.bcr-2018-226355.3","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-119-9-199311010-00010"},{"key":"2025082803043120000_12.2.bcr-2018-226355.4","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-014-2107-x"},{"key":"2025082803043120000_12.2.bcr-2018-226355.5","doi-asserted-by":"crossref","first-page":"2","DOI":"10.4103\/2348-3113.133533","article-title":"Solitary cecal ulcer: a case report and literature review","volume":"2","author":"Shah","year":"2013","journal-title":"Oncology, Gastroenterology and Hepatology Reports"},{"key":"2025082803043120000_12.2.bcr-2018-226355.6","unstructured":"Yh K , Chuang YC , Wl Y . Colonoscopic features of cytomegalovirus colitis and clinical experience. [Internet] SM group: Colonoscopy. https:\/\/pdfs.semanticscholar.org\/55e3\/74362178fa3e7d436587badae3ddfa35331a.pdf (Cited 2018 Apr 27)."},{"key":"2025082803043120000_12.2.bcr-2018-226355.7","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-005-2544-6"},{"key":"2025082803043120000_12.2.bcr-2018-226355.8","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.1992.00400150135025"},{"key":"2025082803043120000_12.2.bcr-2018-226355.9","doi-asserted-by":"crossref","first-page":"88","DOI":"10.1111\/j.1365-2036.2006.00030.x","article-title":"Colonic mucosal lesions associated with long-term administration of non-steroidal anti-inflammatory drugs","volume":"24","author":"Ohkusa","year":"2006","journal-title":"Aliment Pharmacol Ther"},{"key":"2025082803043120000_12.2.bcr-2018-226355.10","doi-asserted-by":"crossref","unstructured":"Deesomsak M , Sukeepaisarnjaroen W , Sawanyawisuth K . Differential diagnosis of ulcers throughout the colon. Images in infectious disease. Rev Soc Bras Med Trop 2014;47 http:\/\/www.scielo.br\/scielo.php?script=sci_arttext&pid=S0037-86822014000300401","DOI":"10.1590\/0037-8682-0043-2014"},{"key":"2025082803043120000_12.2.bcr-2018-226355.11","doi-asserted-by":"publisher","DOI":"10.1001\/archsurg.1982.01380310014004"},{"key":"2025082803043120000_12.2.bcr-2018-226355.12","doi-asserted-by":"crossref","first-page":"334","DOI":"10.1007\/s11894-012-0266-4","article-title":"Cytomegalovirus infection and the gastrointestinal tract","volume":"14","author":"You","year":"2012","journal-title":"Curr Gastroenterol Rep"},{"key":"2025082803043120000_12.2.bcr-2018-226355.13","doi-asserted-by":"publisher","DOI":"10.1111\/j.1572-0241.2006.00869.x"},{"key":"2025082803043120000_12.2.bcr-2018-226355.14","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.4.1498-1504.2004"},{"key":"2025082803043120000_12.2.bcr-2018-226355.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcv.2004.09.032"},{"key":"2025082803043120000_12.2.bcr-2018-226355.16","doi-asserted-by":"crossref","first-page":"133","DOI":"10.4103\/0976-5042.165725","article-title":"Cytomegalovirus infection in gastrointestinal tract: A case series of three patients and review of literature","volume":"6","author":"Ranjan","year":"2015","journal-title":"Journal of Digestive Endoscopy"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-226355","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T10:04:39Z","timestamp":1756375479000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-226355"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,2]]},"references-count":16,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2019,2,9]]},"published-print":{"date-parts":[[2019,2]]}},"alternative-id":["10.1136\/bcr-2018-226355"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-226355","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,2]]}}}