Severe Bleeding due to Cytomegalovirus Esophagitis in a Patient with Diabetes after Interbody Fusion Surgery

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 cl...

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Detalles Bibliográficos
Autores principales: Yamamoto, Shumpei, Iwamuro, Masaya, Miyake, Muneaki, Nishimura, Naoyuki, Mizuno, Motowo, Okada, Hiroyuki
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2019
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859388/
https://www.ncbi.nlm.nih.gov/pubmed/31292384
http://dx.doi.org/10.2169/internalmedicine.2908-19
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author Yamamoto, Shumpei
Iwamuro, Masaya
Miyake, Muneaki
Nishimura, Naoyuki
Mizuno, Motowo
Okada, Hiroyuki
author_facet Yamamoto, Shumpei
Iwamuro, Masaya
Miyake, Muneaki
Nishimura, Naoyuki
Mizuno, Motowo
Okada, Hiroyuki
author_sort Yamamoto, Shumpei
collection PubMed
description 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.
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spelling pubmed-68593882019-11-21 Severe Bleeding due to Cytomegalovirus Esophagitis in a Patient with Diabetes after Interbody Fusion Surgery Yamamoto, Shumpei Iwamuro, Masaya Miyake, Muneaki Nishimura, Naoyuki Mizuno, Motowo Okada, Hiroyuki Intern Med Case Report 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. The Japanese Society of Internal Medicine 2019-07-10 2019-10-15 /pmc/articles/PMC6859388/ /pubmed/31292384 http://dx.doi.org/10.2169/internalmedicine.2908-19 Text en Copyright © 2019 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access journal distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Yamamoto, Shumpei
Iwamuro, Masaya
Miyake, Muneaki
Nishimura, Naoyuki
Mizuno, Motowo
Okada, Hiroyuki
Severe Bleeding due to Cytomegalovirus Esophagitis in a Patient with Diabetes after Interbody Fusion Surgery
title Severe Bleeding due to Cytomegalovirus Esophagitis in a Patient with Diabetes after Interbody Fusion Surgery
title_full Severe Bleeding due to Cytomegalovirus Esophagitis in a Patient with Diabetes after Interbody Fusion Surgery
title_fullStr Severe Bleeding due to Cytomegalovirus Esophagitis in a Patient with Diabetes after Interbody Fusion Surgery
title_full_unstemmed Severe Bleeding due to Cytomegalovirus Esophagitis in a Patient with Diabetes after Interbody Fusion Surgery
title_short Severe Bleeding due to Cytomegalovirus Esophagitis in a Patient with Diabetes after Interbody Fusion Surgery
title_sort severe bleeding due to cytomegalovirus esophagitis in a patient with diabetes after interbody fusion surgery
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6859388/
https://www.ncbi.nlm.nih.gov/pubmed/31292384
http://dx.doi.org/10.2169/internalmedicine.2908-19
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