Cytomegalovirus Colitis with Similar Endoscopic Pattern of Pseudomembranous Colitis in Collagen Vascular Disease

Cytomegalovirus (CMV) infection can cause colitis which is usually manifested with fever, weight loss, anorexia and abdominal pain.Watery diarrhea can be the only manifestation. CMV colitis usually can not be diagnosed according to the clinical findings. Moreover, endoscopic appearance can exactly mimic pseudo-membranous colitis. Here by, we are presenting a patient with fever and watery diarrhea receiving immunosuppressive treatment due to rheumatoid arthritis who had received antibiotics. Pseudo-membranous colitis was revealed during colonoscopy and subsequently metronidazole and vancomycine treatment initiated but no improvement was observed. Finally, according to the positive CMV antibody and the presence of CMV antigen diagnosis was confirmed and valganciclovir for CMV colitis was administered.