Review for 10.1186/s12876-020-01381-1 (2020)

Reviewer’ s report
Title: Colon perforation due to cytomegalovirus infection in a patient with idiopathic
hypereosinophilic syndrome: a case report
Version: 0Date: 01 Jul 2020
Reviewer's report:
The authors relate a case of hypereosinophilic syndrome complicated by CMV colitis and colonic
perforation. CMV colitis as a cause of diarrhea in immunosuppressed patients should be part ofany differential as this association is well recognized. It sounds like an assumption was made thatworsening symptoms were due to a flare of the HES and an adequate fork up (including culturesand CMV viral load) were not conducted before the steroid dose was increased. This is a patientsafety story and should be reminder to readers to appropriately investigate a change in GIsymptoms in long term immunosuppressed patients. The context of HES as the underlyingsyndrome makes this story more unique but perforation as a complication of an acute colitis in animmunocompromised patient is something I would consider a fairly typical differential.
Page 3 Line 43: 'was' should be changed to 'is'
Page 4 line 8: One can deny a history of parasitic infection but testing is required to exclude it.Where stools cultures performed? If so, this should be stated.Page 4 line 17: 'peri-bowel air' is not a typical term. Was there free air or does this implypneumatosis?Page 4 line 26v ' Ganciclovir...was injected to anti-CMV' - this doers not make sense. Pleaserevise.
The discussion contains text repeated from the background. Similarly, a lot of the case
presentation is repeated. This is not needed.Table 1 needs abbreviations explained
Page 6 line 5: This is a long awkward paragraph. Consider revising.
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