Document 0291
 DOCN  M94A0291
 TI    Etiology and management of toxic megacolon in patients with human
       immunodeficiency virus infection.
 DT    9412
 AU    Beaugerie L; Ngo Y; Goujard F; Gharakhanian S; Carbonnel F; Luboinski J;
       Malafosse M; Rozenbaum W; Le Quintrec Y; Department of Gastroenterology,
       Hopital Rothschild, Paris,; France.
 SO    Gastroenterology. 1994 Sep;107(3):858-63. Unique Identifier : AIDSLINE
       MED/94357387
 AB    We report six cases of toxic megacolon in patients with human
       immunodeficiency virus (HIV). One case, at an early stage of HIV
       infection, mimicked a severe attack of Crohn's disease, with a negative
       search for infectious agents. Subtotal colectomy was successfully
       performed with an uneventful postoperative course. The five other cases
       concerned patients with acquired immunodeficiency syndrome at a late
       stage of immunodeficiency. They were related to Clostridium difficile or
       cytomegalovirus (CMV) intestinal infection in two and three patients,
       respectively. One case of CMV colitis presented macroscopically and
       histologically as pseudomembranous colitis. Emergency subtotal
       colectomy, performed in the first four patients with acquired
       immunodeficiency syndrome was followed by a fatal postoperative outcome.
       The last patient treated conservatively by colonoscopic decompression,
       in association with anti-CMV therapy, had a favorable short-term
       outcome. From the experience of our series and data from the literature,
       we discuss the best diagnostic and therapeutic approach to toxic
       megacolon in patients with HIV.
 DE    Adult  Antibiotics/THERAPEUTIC USE  Clostridium difficile  Colectomy
       Colonoscopy  Cytomegalovirus Infections/COMPLICATIONS/DRUG THERAPY
       Enterocolitis, Pseudomembranous/COMPLICATIONS/DRUG THERAPY  Human  HIV
       Infections/*COMPLICATIONS  Male  Megacolon,
       Toxic/*MICROBIOLOGY/RADIOGRAPHY/*THERAPY  Survival Analysis  JOURNAL
       ARTICLE

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