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.