ANCA-Negative Eosinophilic Granulomatosis And Polyangiitis With An Underlying CMV Enteritis Leading To Small Bowel Perforation- A Case Report and Literature Review

Abstract Eosinophilic granulomatosis with polyangiitis (EGPA) is a form of vasculitis that involves the small to medium-sized blood vessels. It can be an ANCA positive or negative disease. EPGA can affect virtually any organ system with the most predominant system being the respiratory system, however, gastrointestinal tract involvement has been reported in a minority of patients. We report a young pleasant gentleman who initially presented with a bout of gastroenteritis and eosinophilia where further investigations showed evidence of vasculitis and the hospital course was complicated by cardiac ischemic event and small bowel perforation mandated resecting a segment of the small bowel surgically. Histopathology of the resected small bowel showed evidence of vasculitis with eosinophilic infiltration and extensive Cytomegalovirus (CMV) infection which could be the main underlying culprit behind bowel perforation.