Crohn’s & Colitis Congress™

Sessions Speakers Exhibitors Floor Plan Buzz

P173 - CLOSTRIDIUM DIFFICILE AND CYTOMEGALOVIRUS COLITIS CO-INFECTION IN PATIENTS WITH STEROID-REFRACTORY ULCERATIVE COLITIS (Room Poster Hall)

Introduction The incidence of Ulcerative colitis(UC) in Korea is increasing rapidly. Corticosteroids, immunomodulators and biologic agents used in the treatment of UC are risk factors for C. difficile or CMV infection. Until now, concomitant infection with CMV and C. difficile is rarely reported, so here we present 3 cases. Case description A 65-year-old, a 68-year-old and a 46-year- old Korean female with history of ulcerative colitis receiving prednisone and an immunomodulator was diagnosed Clostridium difficile infection and cytomegalovirus infection in stool study and sigmoidoscopic biopsy. They were treated with oral metronidazole, oral vancomycin or fecal microbiata transplantation for Clostridium difficile and treated with intravenous ganciclovir for cytomegalovirus infection. The sigmoidoscopic finding improved and the symptoms also had been relieved. Conclusion In patients undergoing an IBD flare and receiving immunosuppressive therapy, a test for C. difficile is recommended. In addition, when a patient’s symptoms persist despite appropriate treatment, early endoscopy with tissue biopsies for CMV should be considered. Further studies are required to optimize the treatment of CDI in IBD flare patients.