Severe bleeding due to cytomegalovirus esophagitis in a patient with diabetes after interbody fusion surgery

Shumpei Yamamoto; Masaya Iwamuro; Muneaki Miyake; Naoyuki Nishimura; Motowo Mizuno; Hiroyuki Okada

doi:10.2169/internalmedicine.2908-19

Severe bleeding due to cytomegalovirus esophagitis in a patient with diabetes after interbody fusion surgery

Shumpei Yamamoto, Masaya Iwamuro, Muneaki Miyake, Naoyuki Nishimura, Motowo Mizuno, Hiroyuki Okada

Research output: Contribution to journal › Article › peer-review

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Abstract

A 49-year-old man with diabetes taking clopidogrel and celecoxib underwent interbody fusion surgery for spinal spondylolysis. Ten days after the surgery, he vomited a large amount of fresh blood. A blood examination revealed hemodynamic failure. Esophagogastroduodenoscopy showed an adherent blood clot and multiple superficial ulcers in the esophagus. Endoscopic hemostasis was successfully achieved. Biopsy specimens from the esophageal ulcer showed positive immunohistochemical staining results for anti-CMV antibodies. The esophageal ulcer improved after the oral administration of ganciclovir. This case emphasizes that CMV esophagitis with bleeding can occur in a diabetic patient with a poor nutritional status due to relative immune dysfunction.

Original language	English
Pages (from-to)	2949-2955
Number of pages	7
Journal	Internal Medicine
Volume	58
Issue number	20
DOIs	https://doi.org/10.2169/internalmedicine.2908-19
Publication status	Published - 2019

Keywords

Cytomegalovirus esophagitis
Diabetes
Esophagogastroduodenoscopy
Hypoalbuminemia

ASJC Scopus subject areas

Internal Medicine

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.2169/internalmedicine.2908-19

Cite this

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title = "Severe bleeding due to cytomegalovirus esophagitis in a patient with diabetes after interbody fusion surgery",

abstract = "A 49-year-old man with diabetes taking clopidogrel and celecoxib underwent interbody fusion surgery for spinal spondylolysis. Ten days after the surgery, he vomited a large amount of fresh blood. A blood examination revealed hemodynamic failure. Esophagogastroduodenoscopy showed an adherent blood clot and multiple superficial ulcers in the esophagus. Endoscopic hemostasis was successfully achieved. Biopsy specimens from the esophageal ulcer showed positive immunohistochemical staining results for anti-CMV antibodies. The esophageal ulcer improved after the oral administration of ganciclovir. This case emphasizes that CMV esophagitis with bleeding can occur in a diabetic patient with a poor nutritional status due to relative immune dysfunction.",

keywords = "Cytomegalovirus esophagitis, Diabetes, Esophagogastroduodenoscopy, Hypoalbuminemia",

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T1 - Severe bleeding due to cytomegalovirus esophagitis in a patient with diabetes after interbody fusion surgery

AU - Yamamoto, Shumpei

AU - Iwamuro, Masaya

AU - Miyake, Muneaki

AU - Nishimura, Naoyuki

AU - Mizuno, Motowo

AU - Okada, Hiroyuki

PY - 2019

Y1 - 2019

N2 - A 49-year-old man with diabetes taking clopidogrel and celecoxib underwent interbody fusion surgery for spinal spondylolysis. Ten days after the surgery, he vomited a large amount of fresh blood. A blood examination revealed hemodynamic failure. Esophagogastroduodenoscopy showed an adherent blood clot and multiple superficial ulcers in the esophagus. Endoscopic hemostasis was successfully achieved. Biopsy specimens from the esophageal ulcer showed positive immunohistochemical staining results for anti-CMV antibodies. The esophageal ulcer improved after the oral administration of ganciclovir. This case emphasizes that CMV esophagitis with bleeding can occur in a diabetic patient with a poor nutritional status due to relative immune dysfunction.

AB - A 49-year-old man with diabetes taking clopidogrel and celecoxib underwent interbody fusion surgery for spinal spondylolysis. Ten days after the surgery, he vomited a large amount of fresh blood. A blood examination revealed hemodynamic failure. Esophagogastroduodenoscopy showed an adherent blood clot and multiple superficial ulcers in the esophagus. Endoscopic hemostasis was successfully achieved. Biopsy specimens from the esophageal ulcer showed positive immunohistochemical staining results for anti-CMV antibodies. The esophageal ulcer improved after the oral administration of ganciclovir. This case emphasizes that CMV esophagitis with bleeding can occur in a diabetic patient with a poor nutritional status due to relative immune dysfunction.

KW - Cytomegalovirus esophagitis

KW - Diabetes

KW - Esophagogastroduodenoscopy

KW - Hypoalbuminemia

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Severe bleeding due to cytomegalovirus esophagitis in a patient with diabetes after interbody fusion surgery

Abstract

Keywords

ASJC Scopus subject areas

UN SDGs

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