Cytomegalovirus Appendicitis in a Patient with Acquired Immunodeficiency Syndrome

Abstract

       Cytomegalovirus (CMV) infection occurs predominantly in the immunocompromised hosts, especially patients with acquired immune deficiency syndrome (AIDS). Gastrointestinal infection is one of the most common manifestations among these patients. However, the prevalence of CMV appendicitis is extremely rare and had not been reported in Thailand. The differences of clinical presentation and laboratory values between immunocompetent and AIDS patients often result in diagnostic difficulty. We report a patient who had been diagnosed as AIDS with no prior history of CMV infection. The patient presented with abdominal pain at right lower quadrant without leukocytosis. Diagnosis of CMV appendicitis was confirmed by histopathological examination of appendectomy specimen. The problems related to making a pathological diagnosis of CMV appendicitis and lines of therapeutic management are reviewed.