In HIV infected patients with low CD4 +ve counts approaching 50 cells/ml, an ascending colitis may occur.
Clinical features may include abdominal pain, rebound tenderness and diarrhoea which may be bloody.
Barium enema and sigmoidoscopy show changes similar to those seen in ulcerative colitis, and CMV inclusions may be seen on jejunal or rectal biopsy.
Important complications include toxic dilatation and perforation.
Treatment with anti-CMV drugs is often successful though relapse is common.
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