Cytomegalovirus vasculitis and colon perforation in a patient with the acquired immunodeficiency syndrome.

We describe a patient with the acquired immunodeficiency syndrome who suffered a colon perforation which we believe was directly attributable to disseminated cytomegalovirus (CMV) infection. Thrombosed vessels within the submucosa and muscle wall contained evidence of CMV vasculitis, while adjacent vessels without viral inclusions were fully patent. This report supports other evidence that CMV may act as a primary etiologic agent of gastrointestinal disease, particularly in the immunocompromised host. The increased recognition of CMV as a cause of significant morbidity in certain gastrointestinal lesions becomes especially important with the advent of newer antiviral therapy specifically directed against CMV infection.