Incidence and clinical significance of colonic cytomegalovirus infection in idiopathic inflammatory bowel disease requiring colectomy.

Evidence of cytomegalovirus infection has been sought in a consecutive series of patients requiring colonic resection for idiopathic inflammatory bowel disease confined to the colon. Colonic tissue was examined by light and electron microscopy for cytomegalovirus inclusion bodies and cytomegalovirus antigen was sought using an immunoperoxidase technique. Cytomegalovirus infection was identified in three of 26 patients studied, but the infection did not appear to influence the course of the colitis. Although all three patients with cytomegalovirus infection needed urgent surgery, none had toxic megacolon. No evidence of cytomegalovirus infection was found in three other patients with toxic megacolon. One patient, who had a rising titre of IgG to cytomegalovirus received treatment with acyclovir which eradicated cytomegalovirus from the colon without altering the course of the colitis.