A case report of cytomegalovirus associated gastritis

The infection caused by cytomegalovirus (CMV) is diverse and depends greatly on the host. It is a common infection in immunocompetent hosts but is generally asymptomatic, or may present with a mononucleosis-like syndrome of fever, lymphadenopathy and pharyngitis. The prevalence of CMV infection ranges from 40 to 100% of the adult population (1). An uncommon manifestation of CMV is organ specific, which can involve the gastrointestinal system. CMV infections in immunocompromised hosts such as those with human immunodeficiency virus (HIV), malignancy, or organ transplantation, can lead to substantial morbidity and mortality. Literature reports on the occurrence of organ specific CMV infection is limited however, to small series and case reports. (2) CMV infection in the stomach can lead to gastric ulcers that are difficult to differentiate from Helicobacter pylori-or non-steroidal anti-inflammatory drug-related ulcers; characteristic morphological features specific to CMV, immunohistological detection of CMV and polymerase chain reaction (PCR) amplification detection of CMV DNA may help differentiate between the two. (3) Further, it is further unclear if and when antiviral therapy is indicated. A recent study suggest that antiviral therapy such as ganciclovir should be considered in immune-incompetent patients and in immunocompetent patients who are male, age 55 years or older, and those with chronic disease. (4)