# HIV Infection Complicated with Cytomegalovirus Colitis: A Case Report of 18F-FDG PET/CT Imaging

## TL;DR

This case report describes an HIV patient with CMV colitis diagnosed using 18F-FDG PET/CT imaging, highlighting its potential for early detection.

## Contribution

The paper demonstrates the diagnostic value of 18F-FDG PET/CT in identifying CMV colitis in immunocompromised patients.

## Key findings

- 18F-FDG PET/CT showed diffuse rectum wall thickening and increased glucose metabolism in CMV colitis.
- FDG concentration detection in the colon wall aids in diagnosing CMV infection and assessing lesion extent.
- Timely antiviral therapy can be initiated with the help of this imaging technique.

## Abstract

Cytomegalovirus (CMV) infection is common in the digestive and central nervous systems and can infect the entire digestive tract from the mouth to the rectum. In immunocompromised patients, CMV infection is prone to develop into CMV disease, especially in Acquired Immune Deficiency Syndrome (AIDS) patients. Severe cases may accelerate the progression of AIDS patients and form systemic CMV infection. Timely diagnosis and treatment are very important for the prognosis of patients.

In this paper, we report a 36-year-old man with a Human Immunodeficiency Virus (HIV) infection complicated with CMV colitis. Three weeks ago, he developed abdominal pain with fresh blood in the stool, accompanied by anal pain. He was found to be HIV positive 8 years ago. An enhanced CT scan showed edema and irregular thickening of the rectal wall, obvious enhancement of the mucosa, and multiple enlarged lymph nodes around. 18F-FDG PET/CT imaging displayed diffuse rectum wall thickening and increased glucose metabolism, and the SUV max was 12.7. There were multiple enlarged lymph nodes around the rectum, glucose metabolism was increased, and the SUVmax was 4.6.

18F-FDG-PET imaging technology has potential value in the diagnosis of CMV colitis, especially in immunocompromised patients. Detection of FDG concentrations in the colon wall can help diagnose CMV infection and understand the extent of the lesion, which is essential for the timely initiation of antiviral therapy.