CMV Ileitis: To Treat or Not to Treat? Implications of Initiating Biologic Therapy for Concurrent Crohn’s Disease
Cytomegalovirus (CMV) enteritis is traditionally thought to be a self-limited infection in immunocompetent individuals. Consequently, current guidelines recommend against treating nonimmunocompromised patients with antiviral therapy. Conversely, recent data suggests that spontaneous resolution occur...
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2019-01-01
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Series: | Case Reports in Gastrointestinal Medicine |
Online Access: | http://dx.doi.org/10.1155/2019/4513795 |
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doaj-f8d570c603ee438ab1502ca779f33bdc2020-11-24T21:32:49ZengHindawi LimitedCase Reports in Gastrointestinal Medicine2090-65282090-65362019-01-01201910.1155/2019/45137954513795CMV Ileitis: To Treat or Not to Treat? Implications of Initiating Biologic Therapy for Concurrent Crohn’s DiseaseKendra T. Stilwell0Jason Estes1Maria T. Kurtz2James M. Francis3David T. Lynch4Anish A. Patel5Department of Internal Medicine, Brooke Army Medical Center, San Antonio, TX, USADepartment of Internal Medicine, Brooke Army Medical Center, San Antonio, TX, USADepartment of Gastroenterology and Hepatology, Brooke Army Medical Center, San Antonio, TX, USADepartment of Gastroenterology and Hepatology, Brooke Army Medical Center, San Antonio, TX, USADepartment of Pathology, Brooke Army Medical Center, San Antonio, TX, USADepartment of Gastroenterology and Hepatology, Brooke Army Medical Center, San Antonio, TX, USACytomegalovirus (CMV) enteritis is traditionally thought to be a self-limited infection in immunocompetent individuals. Consequently, current guidelines recommend against treating nonimmunocompromised patients with antiviral therapy. Conversely, recent data suggests that spontaneous resolution occurs less frequently than previously believed; furthermore, mortality rate in immunocompetent individuals is similar to that of the immunosuppressed. We present a case of a 43-year-old male who was simultaneously diagnosed with CMV ileitis and Crohn’s Disease. When discovered concomitantly, there is no guidance in the current medical literature regarding the benefit of antiviral treatment of the CMV infection prior to initiating biologic therapy versus the risks of withholding treatment, as is currently recommended for nonimmunosuppressed individuals.http://dx.doi.org/10.1155/2019/4513795 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Kendra T. Stilwell Jason Estes Maria T. Kurtz James M. Francis David T. Lynch Anish A. Patel |
spellingShingle |
Kendra T. Stilwell Jason Estes Maria T. Kurtz James M. Francis David T. Lynch Anish A. Patel CMV Ileitis: To Treat or Not to Treat? Implications of Initiating Biologic Therapy for Concurrent Crohn’s Disease Case Reports in Gastrointestinal Medicine |
author_facet |
Kendra T. Stilwell Jason Estes Maria T. Kurtz James M. Francis David T. Lynch Anish A. Patel |
author_sort |
Kendra T. Stilwell |
title |
CMV Ileitis: To Treat or Not to Treat? Implications of Initiating Biologic Therapy for Concurrent Crohn’s Disease |
title_short |
CMV Ileitis: To Treat or Not to Treat? Implications of Initiating Biologic Therapy for Concurrent Crohn’s Disease |
title_full |
CMV Ileitis: To Treat or Not to Treat? Implications of Initiating Biologic Therapy for Concurrent Crohn’s Disease |
title_fullStr |
CMV Ileitis: To Treat or Not to Treat? Implications of Initiating Biologic Therapy for Concurrent Crohn’s Disease |
title_full_unstemmed |
CMV Ileitis: To Treat or Not to Treat? Implications of Initiating Biologic Therapy for Concurrent Crohn’s Disease |
title_sort |
cmv ileitis: to treat or not to treat? implications of initiating biologic therapy for concurrent crohn’s disease |
publisher |
Hindawi Limited |
series |
Case Reports in Gastrointestinal Medicine |
issn |
2090-6528 2090-6536 |
publishDate |
2019-01-01 |
description |
Cytomegalovirus (CMV) enteritis is traditionally thought to be a self-limited infection in immunocompetent individuals. Consequently, current guidelines recommend against treating nonimmunocompromised patients with antiviral therapy. Conversely, recent data suggests that spontaneous resolution occurs less frequently than previously believed; furthermore, mortality rate in immunocompetent individuals is similar to that of the immunosuppressed. We present a case of a 43-year-old male who was simultaneously diagnosed with CMV ileitis and Crohn’s Disease. When discovered concomitantly, there is no guidance in the current medical literature regarding the benefit of antiviral treatment of the CMV infection prior to initiating biologic therapy versus the risks of withholding treatment, as is currently recommended for nonimmunosuppressed individuals. |
url |
http://dx.doi.org/10.1155/2019/4513795 |
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