[A case of cytomegalovirus colitis during chemotherapy for esophageal cancer].

Abstract

We report a case of a patient who developed cytomegalovirus colitis during chemotherapy for esophageal cancer. A 62- year-old man was admitted to our hospital complaining of epigastralgia and dysphagia. He was diagnosed as having esophageal cancer( Mt, type 3, cT3, cN2, cM0, cStage III). Neoadjuvant chemotherapy with 5-fluorouracil( 5-FU) and cisplatin (CDDP) was initiated. However, after 1 course of chemotherapy, the patient experienced a stroke. Subsequently, he was treated with radical chemoradiotherapy. Chemoradiotherapy with low-dose docetaxel was administered. However, he developed interstitial pneumonia, and thus received pulse corticosteroid therapy with methylprednisolone. On the 26th day after steroid therapy, he developed melena. Colonoscopy revealed multiple punched-out ulcers in the transverse colon, and the patient was diagnosed as having cytomegalovirus colitis on the basis of positive cytomegalovirus antigenemia. Intravenous ganciclovir therapy was initiated. On the 13th day after ganciclovir therapy, the patient required an emergency surgery because of perforation-related peritonitis. We identified a perforation in the ascending colon and performed ileocecal resection. Although he was treated with paclitaxel, he died of esophagotracheal fistula and aspiration pneumonitis. We should be aware of cytomegalovirus colitis during chemotherapy and corticosteroid therapy.

• Authors: Masahiro Kitahara, Shinsuke Kanekiyo, Tsunenori Yamamoto, Yusaku Watanabe, Shigeru Takeda, Tomio Ueno, Shigefumi Yoshino, Shoichi Hazama, Masaaki Oka
• Journal: Gan to kagaku ryoho. Cancer & chemotherapy (Gan To Kagaku Ryoho) Vol. 40 Issue 12 Pg. 2127-9 (Nov 2013) ISSN: 0385-0684 [Print] Japan
• PMID: 24394035 (Publication Type: Case Reports, English Abstract, Journal Article)

Chemical References

• Antiviral Agents
• Ganciclovir
• Cisplatin
• Fluorouracil

Topics

• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Antiviral Agents (therapeutic use)
• Cisplatin (administration & dosage)
• Colitis (drug therapy, virology)
• Cytomegalovirus Infections (complications, drug therapy)
• Esophageal Neoplasms (complications, drug therapy, surgery)
• Fatal Outcome
• Fluorouracil (administration & dosage)
• Ganciclovir (therapeutic use)
• Humans
• Male
• Middle Aged