How would you manage a patient with Crohn's disease on a biologic and presents with non-bloody diarrhea, normal-appearing mucosa on sigmoidoscopy but severe colitis on biopsy with a positive CMV stain?
Would you send a CMV DNA PCR in blood, and if you elect to treat with anti-CMV medication, how long would you treat and what parameters would you use, besides clinical improvement, to decide the duration of therapy or assess treatment failure?
1 Answer
Mednet MemberInvited Expert
Infectious Disease · Washington University Division Of Infectious Disease Clinic
Answered on
A few key pieces of information help distinguish CMV colitis from other competing diagnoses in this frequently encountered conundrum. An experienced pathologist will usually be able to tell you:
- If the CMV immunohistochemistry stain has good controls and whether it is floridly positive or scant. Al...
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