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CMV Colitis Alemtuzumab — SCE Infectious Diseases MCQ

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ModerateImmunocompromised HostCMV Colitis AlemtuzumabSCE Infectious Diseases

A 55-year-old man on Alemtuzumab for CLL develops reactivation of CMV (viraemia 35,000 copies/mL) with fever and diarrhoea. Colonoscopy confirms CMV colitis. What is the treatment?

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Correct answer: C — IV Ganciclovir 5 mg/kg BD (dose-adjusted for renal function) for 21 days plus consideration of immunosuppression reduction

Tissue-invasive CMV disease (colitis, pneumonitis) requires treatment-dose IV Ganciclovir 5 mg/kg BD. Prophylactic doses are insufficient. Alemtuzumab causes profound T-cell depletion making CMV reactivation very common. Immunosuppression reduction may not be possible with CLL but should be discussed.

Reference: ECIL-7 2019 – CMV; NICE 2024 – CMV in immunosuppression