Case History
A 64-year-old female hospitalized in our center complained that she
suffered from intermittent diarrhea for more than 11 years, and her
stool was watery, 5-6 times per day. The patient went to the local
hospital 9 years before admission to our hospital , and her laboratory
examination showed reduced globulin(14.3g/L), hypokalemia(3.07mmol/L),
and hypocalcemia(2.03mmol/L). She underwent colonoscopy, and revealed
scattered congestion and erosion throughout the colon, and chronic
inflammation was found in intestinal mucosa biopsy. Meanwhile, she
received chest computed tomography(CT) examination, which showed that
there was a mass(about 5*4*4cm) in the right mediastinum with rich blood
supply. Subsequently, she was scheduled for mediastinal tumor resection,
and the histopathological report of the tumor was type A thymoma (World
Health Organization classification ). The symptom of diarrhea could be
alleviated with intermittent medication. However, the disease continued
to recur.
The patient had severe diarrhea, abdominal distension, fatigue,
dizziness, weight loss, and numbness of hands and feet two months before
coming to hospital. She then attended the local hospital again.
Laboratory findings are showed in Table 1 .
Gastroscopy and colonoscopy were performed. The results of gastroscopy
showed swelling of the gastric mucosa and gastric body with scattered
erythema. The biopsy results showed that CMV immunohistochemistry was
positive, and Helicobacter pylori was negative. Meanwhile,
colonoscopy revealed rough swelling, hyperemia and erosion of the
descending colon mucosa, rough rectal mucosa and obvious congestion and
swelleing of other colons mucosa. Immunohistochemistry of biopsy showed
CMV+, PCK+, CD4+, CD8+, Ki-67+. Therefore the final diagnosis of the
patient was CMV gastroenteritis. She received cefotaxime and
levofloxacin for anti-infection, ganciclovir (250mg Q12h ×14 days)
antiviral treatment, human immunoglobulin (10g×5d), potassium
supplementation, spasmolysis, ,and oral montmorillonite powder and
probiotics. However, she still had recurrent symptoms and then came to
our hospital.