COVID-19 and Cytomegalovirus Co-infection: A Challenging Case of a Critically Ill Patient with Gastrointestinal Symptoms

Pedro Hf Amaral; Bernadete Mc Ferreira; Sergio Roll; Precil Dmm Neves; Luca Ga Pivetta; Sara Mohrbacher; Eduardo Rm Dias; Victor Ah Sato; Érico S Oliveira; Leonardo Vb Pereira; Alessandra M Bales; Luciana L Nardotto; Jéssica N Ferreira; Américo L Cuvello-Neto; Pedro R Chocair

doi:10.12890/2020_001911

COVID-19 and Cytomegalovirus Co-infection: A Challenging Case of a Critically Ill Patient with Gastrointestinal Symptoms

Eur J Case Rep Intern Med. 2020 Sep 2;7(10):001911. doi: 10.12890/2020_001911. eCollection 2020.

Authors

Affiliations

¹ Gastrointestinal Surgery Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazil.
² Internal Medicine Service, Oswaldo Cruz German Hospital, São Paulo-SP, Brazi.

Abstract

COVID-19 is a severe disease that has reached pandemic status. To the best of our knowledge, we describe the first case of COVID-19 and cytomegalovirus (CMV) co-infection in a critically ill patient. We discuss the challenge of establishing the diagnosis as well as the management of tissue-invasive gastrointestinal CMV infection (TI-GI CMV) simulating vascular involvement and intestinal obstruction in a critically ill patient.

Learning points: We describe a case of COVID-19 and cytomegalovirus (CMV) co-infection in a critically ill patient.Clinical symptoms simulated mesenteric vascular involvement and intestinal obstruction.The successful management of invasive CMV colitis in a patient with COVID-19 with atypical symptoms is described.

Keywords: COVID-19; Colitis; cytomegalovirus; immunosuppression; intensive care unit.