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Cytomegalovirus Enterocolitis in Immunocompetent Young Children: A Report of Two Cases and Review of the Literature

Sue, Paul K. MD, CM; Salazar-Austin, Nicole M. MD; McDonald, Oliver G. MD, PhD; Rishi, Arvind MD, MB BS; Cornish, Toby C. MD; Arav-Boger, Ravit MD

Pediatric Infectious Disease Journal: May 2016 - Volume 35 - Issue 5 - p 573–576
doi: 10.1097/INF.0000000000001080
Instructive Case

Cytomegalovirus (CMV) causes significant morbidity and mortality in congenitally infected children and immunocompromised hosts. Among healthy individuals, CMV is generally thought to cause mild, self-limited illness. CMV enterocolitis, in particular, is rarely considered among immunocompetent children presenting with diarrhea. We describe 2 cases of invasive CMV colitis in immunocompetent infants presenting with diarrhea and review the literature to date on this topic. Although invasive CMV enterocolitis has been sporadically reported among immunocompetent children, it remains an underrecognized cause of infectious diarrhea in this population and indications for antiviral therapy are lacking. We propose that CMV should be included in the differential diagnosis of intractable diarrhea in immunocompetent children.

From the *Division of Pediatric Infectious Diseases, Department of Pediatrics, Johns Hopkins Hospital, Baltimore, Maryland; Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas; Division of Microbiology, Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland; §Department of Pathology, Microbiology, and Immunology, Vanderbilt University Medical Center, Nashville, Tennessee; and ¶Department of Pathology, Hofstra Northwell School of Medicine, Lake Success, New York.

Accepted for publication October 16, 2015.

P.K.S. received funding from grant NIH T32 AI052071; N.M.S. received funding from grant NIH T32 AI052071, and R.A.-B. received funding from grant NIH R01 093701-04. The other authors have no funding or conflicts of interest to disclose.

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Address for correspondence: Paul K. Sue, MD, CM, Division of Pediatric Infectious Diseases, Department of Pediatrics, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390–9063. E-mail: paul.sue@utsw.edu.

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