Characteristic endoscopic findings and risk factors for cytomegalovirus-associated colitis in patients with active ulcerative colitis

Figure 1 Clinical course of cytomegalovirus-associated colitis in patients with moderate to severe ulcerative colitis. Flow chart of the 171 patients admitted to our department with active UC. ¹Seven patients with a history of CMV-associated colitis or anti-CMV treatment were excluded; ²Fifteen patients who had not undergone colonoscopy and examination using the CMV antigenemia assay were also excluded; ³Out of 34 UC patients with CMV-associated colitis, 26 received GCV antiviral therapy. After GCV therapy, 13 patients achieved remission, but 13 required colectomy. Eight patients did not receive GCV antiviral therapy, 4 of whom underwent colectomy; ⁴The remaining 115 UC patients not diagnosed with CMV-associated colitis received treatment for active UC, of which 81 achieved remission. Of the remaining patients, some improved but did not fulfill remission criteria, while others required a second treatment, hospitalization, or colectomy. CMV: Cytomegalovirus; UC: Ulcerative colitis; Ag: Antigenemia; GCV: Ganciclovir.

Figure 2 Endoscopic images of cytomegalovirus-associated colitis in patients with active ulcerative colitis. A-C: Deep ulcer; D-G: Punched-out ulcer; H-J: Geographical ulcer; K: Longitudinal ulcer; L: Mucosal defect.