Recurrent corticosteroid-resistant cytomegalovirus infection complicating ulcerative colitis responding to antiviral treatment: Case report

Cytomegalovirus is a common opportunistic infection that often affects individuals with impaired immune function. It may present with a variety of clinical manifestations. Treatment for ulcerative colitis (UC) usually requires immunosuppressants and steroids, increasing patients' susceptibility to cytomegalovirus infection. We report the case of a 53-year-old female patient with corticosteroid-resistant UC and recurrent cytomegalovirus infection. The patient had exacerbations, and the diagnosis of cytomegalovirus infection was confirmed through serology and detection of high levels of cytomegalovirus DNA in biopsies using quantitative polymerase chain reaction (PCR). After requiring intravenous ganciclovir, the patient improved. However, she had further relapses requiring treatment with foscarnet, with marked improvement in symptoms and endoscopic results. This case shows the importance of evaluating acute cytomegalovirus infections in patients with corticosteroid resistance. Quantitative PCR appears to be a valuable tool in guiding treatment decisions. In addition, the case is evidence for the satisfactory efficacy of foscarnet in managing cytomegalovirus infections.