Challenges in Managing Cytomegalovirus Colitis in a Complex Case of Ulcerative Colitis With Hyposplenism and Ustekinumab Therapy

ABSTRACT Colitis secondary to cytomegalovirus (CMV) infection is a recognized complication in patients with ulcerative colitis. This case report details a patient with a background of ulcerative colitis with resultant hyposplenism on ustekinumab therapy who presented with CMV colitis. The presence of hyposplenism with the use of ustekinumab resulted in challenges when treating the CMV infection due to the absence of immune response and required individual tailoring of therapy with higher doses of ganciclovir and valganciclovir according to trough level measurement.