Cytomegalovirus disease is a frequent infection of the early posttransplant period. Late-onset disease is common in patients receiving chemoprophylaxis. Here, we report 2 cases of cytomegalovirus gastritis, occurring late in the posttransplant course, with undetectable viral load in the patients' blood, in patients not receiving valganciclovir prophylaxis and not having the classic risk factors described herein. Patients presented with chronic diarrhea and gastric bleeding late in the posttransplant course. Diagnoses were based on endoscopic gastric biopsy. Patients were treated successfully with ganciclovir/valganciclovir. Because preventive strategies are unclear in late-onset disease in persons at low risk, early diagnosis and treatment are crucial.
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