Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a subacute history of worsening hematochezia, non-bloody diarrhea, and crampy abdominal pain. Significant for [Immunocompromised state/HIV/Post-transplant/Corticosteroid use]. Associated symptoms include low-grade fevers, unintentional weight loss, and malaise. Denies recent travel or antibiotic use.
Clinical Examination Findings
General: Patient appears chronically ill, pale, and cachectic. Abdomen: Soft, non-distended, with diffuse tenderness to deep palpation, primarily in the left lower quadrant. No rebound or guarding. Bowel sounds: Hyperactive. Rectal exam: Positive for bright red blood on digital rectal examination.
Treatment Protocol
Initiate intravenous Ganciclovir 5mg/kg every 12 hours. Monitor CBC for neutropenia and renal function for creatinine clearance. Consider transition to oral Valganciclovir upon clinical improvement. Optimize immunosuppression if clinically feasible. Consult Infectious Disease for duration of therapy and monitoring.