CMV-Related Gastric Ulcer and Gastroduodenitis in an Immunocompetent Patient: A Case Report and Literature Review

Abstract

Background. Cytomegalovirus (CMV)- related gastroduodenal infection is rare in immunocompetent hosts, and although it is considered a self-limiting condition in most cases, there is scarce literature to assert its management. Case Presentation. We report a case of a 66-year-old immunocompetent male patient diagnosed with a giant gastric ulcer caused by CMV infection. The ulcer manifested as refractory vomiting and melena. Rapid and full resolution was observed on proton-pump inhibitor (PPI) monotherapy. Conclusion. Gastric CMV infection might mimic an advanced gastric tumor in individuals with an intact immune system. The condition is rare, and the diagnosis is challenging and oftentimes overlooked. However, a rapid resolution has been documented in all cases, even without antiviral therapy.

Cytomegalovirus-Related Gastritis in an Immunocompetent Host Presenting With Infectious Gastroparesis

“…After PubMed research for case reports up to September 2023 (keywords: Cytomegalovirus AND immunocompetent AND gastric ulcer OR gastritis), of the 26 search results, we found 8 English articles on CMV gastric disease in immunocompetent adults eligible for inclusion (Table 1). Unlike to the case we report, all patients were male, [9][10][11][12][13][14][15][16] and most of them were young adults with no underlying diseases. Similar to our case, CMV infection of the upper GI tract in immunocompetent hosts has been reported to cause multiple gastric erosions and ulcers similar to H. pyloriand nonsteroidal anti-inflammatory drugs-related ulcers.…”

Pharmacological Mechanism of Aucklandiae Radix against Gastric Ulcer Based on Network Pharmacology and In Vivo Experiment

“…Our GO enrichment analysis results also showed that the effect of AR against GU involved the responses to lipopolysaccharide, response to a molecule of bacterial origin, and response to bacterium, indicating that AR could reduce the damage of harmful factors to the gastric mucosa caused by Helicobacter pylori and other bacteria. In addition, according to the KEGG pathway enrichment results, the human cytomegalovirus infection pathway was related to the anti-ulcer effect of AR, and studies have shown that cytomegalovirus virus infection can cause GU [46], suggesting that AR can be used to treat GU caused by the cytomegalovirus virus.…”

Severe gastrointestinal cytomegalovirus infection with underlying common variable immunodeficiency in a middle aged lady

“…Persistent infection evolved into gastric outlet narrowing giving rise to obstructive symptoms. 2 It may mimic gastric malignancy in chronic cases. Upper gastrointestinal involvement is less common and the usual presentation is upper GI bleed.…”

“…1 Symptomatic gastric CMV disease most commonly involves antrum causing antral gastritis and thickening of the pylorous. 2 It may lead to gastric outlet obstruction in extreme cases. Gastro intestinal CMV may manifest with or without detectable viremia.…”