Abstract

GUTIERREZ SAMANIEGO, María; RODRIGUEZ CUELLAR, Elías; PEREZ ZAPATA, Ana Isabel  and  DE LA CRUZ VIGO, Felipe. Intestinal Perforation for Cytomegalovirus in Immune Reconstitution Syndrome. Rev Cubana Cir [online]. 2019, vol.58, n.4  Epub May 25, 2020. ISSN 1561-2945.

Immune reconstitution syndrome occurs due to increased immunocompetence in previously immunocompetent patients. The condition is frequent in patients with human immunodeficiency virus infection who have started a highly active antiretroviral therapy. In certain cases, the syndrome can lead to a paradoxical worsening of a previous infection. Cytomegalovirus is an opportunistic germ that, during an immune reconstitution syndrome, can lead to multifocal intestinal perforation and secondary peritonitis, in cases that are difficult to treat. The syndrome is more frequent in patients with CD4 lymphocyte count below 50/mm3 at the time of starting antiretroviral treatment. The objective is to communicate this situation through a clinical case presentation in order to facilitate suspicion as soon as possible, and to carry out appropriate treatment. We present the case of a patient with a recently diagnosed human immunodeficiency virus, under treatment with highly active antiretroviral therapy, who attended the emergency department with an acute abdomen secondary to perforation due to cytomegalovirus. Infection carries significant morbidity and mortality, and early diagnosis is essential and intravenous antiviral treatment should be started early, generally associated with surgical treatment.

Keywords : intestinal perforation; citomegalovirus; human immunodeficiency virus; immune reconstitution syndrome.

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