# Cytomegalovirus Infection of the Gastrointestinal Tract in Patients on Hemodialysis: A Case Report and Literature Review

## TL;DR

A case report and literature review show that cytomegalovirus can cause gastrointestinal issues in hemodialysis patients, requiring early detection and treatment.

## Contribution

This paper adds a new case of CMV colitis in a hemodialysis patient and reviews existing literature on the topic.

## Key findings

- CMV infection in the GI tract was diagnosed in a hemodialysis patient through biopsy and treated successfully with valganciclovir.
- A literature review identified 24 cases of CMV GI tract infections in dialysis patients, with symptoms like hematochezia and diarrhea.
- Clinicians should consider CMV infection in dialysis patients with unexplained bloody diarrhea and perform endoscopy and biopsy promptly.

## Abstract

Cytomegalovirus (CMV) infection is widespread in immunocompromised people, and several cases of CMV infections of the gastrointestinal (GI) tract have been reported in these individuals. We present a case of an immunocompetent patient on hemodialysis (HD) who developed CMV colitis. We also conducted a review of the literature on CMV GI tract infections among patients with chronic kidney disease undergoing dialysis. A 46-year-old man with a history of end-stage renal disease and undergoing HD developed severe diarrhea and hematochezia. A colonoscopy revealed ulcers, and CMV infection was identified in the biopsy sample. We successfully treated the patient with valganciclovir for 2 months. Our review of the literature yielded 21 articles and 24 cases of CMV GI tract infection in patients undergoing dialysis, including the current case. Hematochezia and diarrhea were purported to serve as indicators of CMV GI tract infection among patients on dialysis. Thus, clinicians should suspect CMV infection of the GI tract in dialysis patients, who experience unexplained bloody diarrhea, and promptly perform a GI endoscopy and biopsy.