Literature Review
We searched all cases up to October 2022 using China National Knowledge Infrastructure database, Wangfang database and China Science and Technology Journal Database, and PubMed database. Keywords included Good’s syndrome, Good syndrome, thymoma, diarrhea, Cytomegalovirus infection. According to the literature, 10 patients diagnosed with GS and CMV gastrointestinal infection meet our inclusion criteria (Table2 ).
It is reported that 8 patients had diarrhea without specific endoscopic manifestation. Although one case showed normal macroscopic appearance of the colon, the random colonic biopsy revealed CMV inclusion bodies[7]. Two cases also manifested as chronic diarrhea due to CMV enteritis and ulcerative colitis[5, 15]. All patients received immunoglobulin replacement therapy. Except for two cases (one case of CMV infection confirmed by necropsy, and one case did not describe the regime of antiviral agent), eight cases received ganciclovir as the initial treatment for CMV, and four cases switched to Foscarnet due to no response or recurrence of diarrhea, and two cases finally switched to cidofovir due to no response or intolerance of Foscarnet. Four patients deteriorated and died due to fulminant bronchopneumonia, sepsis, recurrent colitis and colonic perforation, and neurological deterioration with a refractory supraconvulsive state, respectively.