In CMV colitis, which finding on colonoscopy is characteristic?

In the context of cytomegalovirus (CMV) colitis, the characteristic finding on colonoscopy is multiple ulcers that contain CMV-infected cells. This is due to the pathophysiology of CMV, which primarily causes ulcerations in the gastrointestinal tract, particularly in immunocompromised individuals such as those with HIV/AIDS, transplant recipients, or patients on immunosuppressive therapy.

The appearance of these ulcers is distinct and often referred to as a "serpiginous" pattern, reflecting the viral infection and its effect on the mucosal layer of the colon. Histological examination typically reveals the presence of enlarged cells with intranuclear inclusions, known as owl-eye inclusions, confirming the diagnosis of CMV infection. This finding is essential for distinguishing CMV colitis from other types of colitis, such as ulcerative colitis or Crohn's disease, which have different pathologies and manifestations.

Other potential findings in colitis can include granulomas or necrosis, but these are not typical for CMV infection specifically. Hemorrhagic lesions may occur in various colitis forms as well, but they are not a defining characteristic of CMV colitis, making multiple ulcers with CMV cells the most accurate