Quick Shot #6 Answer

Answer: Cytomegalovirus

 

Cytomegalovirus is a particular concern in this person with both UC and on chemotherapy for breast cancer. CMV colitis can mimic a UC flare, and the presence of a flare can increase susceptibility to CMV colitis. While C. difficile often does cause pseudomembranes in patients with IBD, this was already excluded by negative stool test. Cryptosporidium parvum is an opportunistic infection that can cause diarrhea but is better evaluated for by stool test than biopsy. EBV typically does not cause colitis. While she is immunocompromised, her degree of immunosuppression is likely not severe enough to develop Mycobacterium avium, and therefore CMV is a more likely opportunistic pathogen.