Dual Infection with Non-Self-Limited Cytomegalovirus and Shigella of the Colon in Non-Immunocompromised Patient: Report of a Case

Cytomegalovirus infections are usually found in immunocompromised persons and rarely present in those who are immunocompetent. We report a case of an elderly man presenting with watery diarrhea, abdominal pain, and fever for one month. Infection of Shigella flexneri was proved by stool culture at first. Clinical symptoms did not improve with antibiotics treatment. In contrast, diffuse abdominal distention and megacolon developed. Then the diagnosis of CMV colitis was made by colonoscopy with mucosal biopsy. Treatment with Ganciclovir (10 mg/kg/day I.V. in 2 divided doses) for 2 weeks resulted in resolution of clinical symptoms with no noticeable side effects. There was no relapse during 6 months follow-up. We report, to our knowledge, the second case of dual infection of the colon with CMV and Shigella in an immunocompetent patient and the first non-self-limited example.