Fatima Zahra ELRhaoussi, Laïla Elidrissi*, Zineb Boukhal, Mohamed Tahiri, Fouad Haddad, Wafaa Hliwa, Ahmed Bellabah and Wafaa Badre

Gastroenterology Department, Ibn Rochd University Hospital, Casablanca, Morocco

*Corresponding Author: Laïla Elidrissi, Gastroenterology Department, Ibn Rochd University Hospital, Casablanca, Morocco.

Received: March 28, 2025; Published:March 31, 2025

Abstract

Background: Acute severe colitis (ASC) is a potentially life-threatening complication of inflammatory bowel disease (IBD). Cytomegalovirus (CMV) colitis has been increasingly recognized in the context of ASC. Quantitative polymerase chain reaction (PCR) testing has emerged as a highly sensitive and rapid diagnostic method. However, the pathogenic role of CMV in ASC remains debated. This study aims to assess the prevalence of CMV colitis in patients with ASC, identify associated risk factors, and evaluate its impact on corticosteroid resistance.

Methods: This retrospective, single-center study included patients admitted in 2023 for ASC secondary to IBD. The diagnosis of CMV colitis was established by the detection of CMV DNA in colonic biopsies using quantitative PCR. Demographic, clinical, laboratory, and therapeutic data were systematically collected and analyzed.

Results: A total of 31 patients were included (median age: 31 years; 61% male). Ulcerative colitis accounted for 87% of cases. In 64% of patients, ASC was the initial presentation of IBD, and 84% had extensive colonic involvement. CMV colitis was diagnosed in 35% of cases based on tissue PCR. Antiviral therapy was initiated in 10 patients, with one death prior to treatment. Seven patients were steroid-refractory; among them, four underwent colectomy. Comparison between the responsive and refractory groups demonstrated that a CMV colitis was significantly associated with corticosteroid non-response (p=0.023). CMV colitis was significantly associated with disease extent (p=0.042). CMV colitis was more prevalent among corticosteroid-refractory patients (OR = 7, 95% CI: 1.35–36.31, p = 0.021), and remained an independent predictor of steroid non-response after multivariate analysis (OR = 7.336, 95% CI: 1.376–39.11, p = 0.020).

Conclusion: In this cohort, CMV colitis was identified in 35% of patients, with extensive colonic involvement emerging as a significant associated factor. While the pathogenic role of CMV in ASC remains debated, our findings suggest a potential contribution beyond a bystander effect.

Keywords: Acute Severe Colitis; Inflammatory Bowel Disease; Cytomegalovirus Colitis; Corticosteroid Responsiveness

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Citation

Citation: Laïla Elidrissi., et al. “Cytomegalovirus in Acute Severe Colitis: A Prevalent Pathogen or Common Passenger?".Acta Scientific Gastrointestinal Disorders 8.5 (2025): 62-67.

Copyright

Copyright: © 2025 Laïla Elidrissi., et al This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.