Case Report : Severe CMV Colitis in a Patient with Follicular Lymphoma after Chemotherapy
Chantana Polprasert MD*, Chatchawan Wongjitrat MD**, Naruemon Wisedopas MD***
Affiliation : * Division of Hematology, Department of Medicine, Srinakarinwirot University, Bangkok, Thailand ** Division of Gastroenterology, Department of Medicine, Srinakarinwirot University, Bangkok, Thailand *** Department of Pathology, Chulalongkorn University, Bangkok, Thailand
Background : Cytomegalovirus (CMV) can infect immuno-compromised host, especially in HIV and bone marrow
transplantation patients. CMV colitis was reported after receiving chemotherapy in a solid tumor and aggressive Non-
Hodgkin’s lymphoma, but not yet in indolent lymphoma patients.
Case Report : In the present report, a 64-year-old woman was re-admitted with watery diarrhea after eight cycles of chemotherapy
for Follicular lymphoma. She had hyponatremia, hypokalemia, and hypocalcemia, which were the consequences of severe
diarrhea. After two weeks of continuous diarrhea, she was set for colonoscopy, which showed multiple ulcers along the colon.
Pathological results were found to be consistent with CMV colitis. Her diarrhea symptom improved after receiving ganciclovir.
Conclusion : CMV colitis could occur in indolent lymphoma patients who receive R-CVP regimen (rituximab, cyclophosphamide,
vincristine, and prednisolone). Patients exhibiting severe and prolonged diarrhea should be investigated for definite diagnosis
in order to receive proper treatment.
Keywords : Cytomegalovirus, CMV colitis, Follicular lymphoma
