30th July 2023

A 37-year-old man with known ulcerative colitis has been on 5-aminosalicylic acid (5-ASA) therapy as maintenance for several years

A 37-year-old man with known ulcerative colitis has been on 5-aminosalicylic acid (5-ASA) therapy as maintenance for several years. His symptoms are well-controlled, and the most recent annual colonoscopy shows mild inflammation.
However, over the last week, he has been experiencing bloody diarrhoea, abdominal pain, fever and myalgia and subsequently presented to A&E. CT showed oedematous changes in the large bowel, and inflammatory markers were raised. An inpatient flexible sigmoidoscopy was arranged, which revealed histology findings of inclusion bodies on a hematoxylin and eosin staining of the biopsy samples. Subsequently, cytomegalovirus (CMV) PCR investigations came back positive.

Which of the following therapeutics would you consider initiating for the patient?

Select the SINGLE most appropriate option from the list below. Select ONE option only.