Cytomegalovirus infective gastritis in an immunocompetent host misdiagnosed as malignancy on upper gastrointestinal endoscopy: a case report and review of literature

Xiong, Xin; Liu, Fang; Zhao, Weilin; Ji, Xinhua; Chen, Weigang; Zou, Hong; Li, Feng

doi:10.1016/j.humpath.2018.12.005

Cited by 14 publications

(8 citation statements)

References 9 publications

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“…Quantitative PCR technique can help establish the diagnosis when histopathologic testing is inconclusive or negative [14]. Occasionally, repeated endoscopy and careful observation of deep biopsies are conducive to establish the diagnosis [16].…”

Section: Discussionmentioning

confidence: 99%

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

Beany

Rainis

2021

Case Reports in Gastrointestinal Medicine

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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.

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Section: Discussionmentioning

confidence: 99%

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

Beany

Rainis

2021

Case Reports in Gastrointestinal Medicine

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“…9 Gastric wall thickening associated with overlying erosions may simulate carcinoma or lymphoma. 10 Similarly, erosions, ulcers and tumefactive mural thickening have been described in the duodenum. 11 CMV infection often elicits macrophage-rich inflammation associated with neutrophils, fibrin, and granulation tissue, but immunocompromised patients may mount little to no inflammatory response.…”

Section: Cytomegalovirus (Cmv)mentioning

confidence: 90%

“…Oesophageal ulcers are large and serpiginous, and are localised in the mid and distal oesophagus 9 . Gastric wall thickening associated with overlying erosions may simulate carcinoma or lymphoma 10 . Similarly, erosions, ulcers and tumefactive mural thickening have been described in the duodenum 11 .…”

Section: Viral Infections Of the Upper Gastrointestinal Tractmentioning

confidence: 99%

Infectious diseases of the upper gastrointestinal tract

Panarelli

2020

Histopathology

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A broad spectrum of pathogens produce gastrointestinal disease. The ongoing spread of human immunodeficiency virus/acquired immune deficiency syndrome, the increased use of immunosuppressive therapy and the persistence of overcrowding and suboptimal sanitation in underdeveloped areas facilitate both disease transmission from environmental and foodborne sources and person‐to‐person transmission. Clinicians increasingly rely on endoscopic biopsy sample interpretation to diagnose gastrointestinal infections. Thus, pathologists must be aware of diagnostic features of a variety of microbial pathogens. Detection with molecular techniques also allows for correlation between infectious agents and their histopathological features, which has expanded our knowledge of the inflammatory changes produced by infectious agents. This review covers infectious disorders of the upper gastrointestinal tract encountered in surgical pathology. Clinical, endoscopic and pathological features are presented. The review emphasises morphological features of viruses, bacteria, fungi and parasites that may be found in tissue samples, and the inflammatory patterns that they produce. Differential diagnoses and useful ancillary techniques are discussed.

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“…Cowdry inclusions can be seen on pathology [28,41,42]. CMV may also cause gastritis [43], esophagitis [44], ileitis [45], obstruction [46], and protein-losing hypertrophic gastropathy [47]. Diagnosis is made with endoscopy and biopsy proven CMV isolation from appropriate mucosa.…”

Section: Gastrointestinalmentioning

confidence: 99%

Cytomegalovirus in Lung Transplant

Rosenheck¹,

otros²,

Nunley³

2021

obm transplant

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Lung transplantation is a therapeutic option for patients with advanced lung diseases. Lung transplant outcomes have improved over time with improvements in the management of these complex patients. Cytomegalovirus is a common opportunistic organism affecting all solid organ transplant recipients. Characteristics unique to lung transplantation can make this virus difficult to manage, with myriad complications including graft failure and death. Ongoing research into and understanding of cytomegalovirus has opened exciting new avenues of management. We discuss the various manifestations of CMV related pathologies in the lung transplant recipient. We discuss current mainstays of risk stratification, diagnosis, and treatment, as well as present new and evolving concepts. Current medications are highly effective at preventing and treating CMV manifestations, but may be poorly tolerated. A new generation of therapies carry the promise of efficacy, with a greater safety profile and improved tolerance of adverse effects. We discuss host-virus immune interactions, specifically how these can be utilized in clinical practice to individualize the cytomegalovirus related care of lung transplant recipients. Finally, we turn our attention to the near horizon as we continue to evolve the care of this unique population.

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Cytomegalovirus infective gastritis in an immunocompetent host misdiagnosed as malignancy on upper gastrointestinal endoscopy: a case report and review of literature

Cited by 14 publications

References 9 publications

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

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

Infectious diseases of the upper gastrointestinal tract

Cytomegalovirus in Lung Transplant

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