Cytomegalovirus infections: The Daily PANCE Blueprint
A 32-year-old immunocompromised male is diagnosed with cytomegalovirus colitis. Which of the following is the most appropriate initial treatment?
A. Oral antibiotics
B. Intravenous ganciclovir
C. High-dose corticosteroids
D. Reassurance and observation
E. Initiation of antiretroviral therapy alone
Answer and topic summary
The answer is B. Intravenous ganciclovir
Cytomegalovirus (CMV) colitis and associated GI diseases are uncommon, but critical complications of AIDS. They typically occurs when the CD4 cell count is <50 cells/microL. Clinical symptoms include nausea, fever, abdominal pain, diarrhea, and malaise. Diagnostic tests include endoscopy with biopsy and tissue CMV PCR. Endoscopy may reveal localized areas of friable, erythematous mucosa with submucosal hemorrhage and mucosal ulcerations. Treatment is ganciclovir or foscarnet for 3-6 weeks. Complications include hemorrhage, bowel perforation, and toxic megacolon.
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Smarty PANCE Content Blueprint Review:
Covered under ⇒ PANCE Blueprint Infectious Disease ⇒ ⇒
Also covered as part of the Internal Medicine PAEA Rotation EOR topic list
