Case report - Cytomegalovirus hemorrhagic gastritis

A 36-year-old male with acquired immune deficiency syndrome (AIDS) presente d with intractable nausea and vomiting of 1 week's duration that was not at tributable to his medications. An esophagogastroduodenoscopy showed hemorrh agic and necrotic gastric mucosa but no ulcers were found. Histopathology r evealed viral inclusions consistent with cytomegalovirus (CMV) disease of t he stomach. The patient received 6 weeks of intravenous ganciclovir with re solution of symptoms and endoscopic findings. Cytomegaloviral involvement o f the stomach is rare, even in immunocompromised patients. Characteristic f indings on upper endoscopy are punched-out gastric ulcers. This is a rare c ase of CMV disease of the stomach presenting as hemorrhagic, necrotic gastr itis with inflammatory bridging.