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 journalArticle

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 languageEnglish
Pages (from-to)2949-2955
Number of pages7
JournalInternal Medicine
Volume58
Issue number20
DOIs
Publication statusPublished - Jan 1 2019

Fingerprint

Esophagitis
Cytomegalovirus
Ulcer
clopidogrel
Celecoxib
Hemorrhage
Endoscopic Hemostasis
Spondylolysis
Digestive System Endoscopy
Spinal Fusion
Ganciclovir
Nutritional Status
Ambulatory Surgical Procedures
Esophagus
Oral Administration
Anti-Idiotypic Antibodies
Thrombosis
Hemodynamics
Staining and Labeling
Biopsy

Keywords

  • Cytomegalovirus esophagitis
  • Diabetes
  • Esophagogastroduodenoscopy
  • Hypoalbuminemia

ASJC Scopus subject areas

  • Internal Medicine

Cite this

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.

In: Internal Medicine, Vol. 58, No. 20, 01.01.2019, p. 2949-2955.

Research output: Contribution to journalArticle

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. In: Internal Medicine. 2019 ; Vol. 58, No. 20. pp. 2949-2955.
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