Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2015 Jul 6:2015:bcr2014206991.
doi: 10.1136/bcr-2014-206991.

Gastritis as a manifestation of primary CMV infection in an immunocompetent host

Pedro Crespo  1 , Nuno Dias  1 , Nuno Marques  1 , José Saraiva da Cunha  1
Affiliations
Case Reports

Gastritis as a manifestation of primary CMV infection in an immunocompetent host

Pedro Crespo et al. BMJ Case Rep. .

Abstract

The cytomegalovirus (CMV) disease spectrum is very wide, with symptomatic infections being rare in immunocompetent hosts. We present the case of a 31-year-old immunocompetent man diagnosed with CMV gastritis in the context of primary infection. The most important laboratory abnormalities leading to diagnosis were: elevation of liver enzymes (3-4× the upper limit of normal), thrombocytopenia (133 G/L), lymphocytosis (55%-4.2 G/L) with activated lymphocytes, CMV IgM positive (negative IgG), CMV viral load of 5700 copies/mL (real-time PCR); autoimmunity study showed antiparietal cell antibodies; abdominal ultrasonography detected homogenous splenomegaly (14.6×13.4 cm) and endoscopy unveiled superficial erosions of the gastric antrum that were biopsied. Anatomopathology and immunohistochemistry of the samples identified cytomegalic inclusions in endothelial cells. Cellular and humoral immunity deficits were excluded. As the patient developed severe asthaenia, adynamia and epigastric pain, he was administered gancyclovir 5 mg/kg intravenously twice daily for 7 days, with resolution of symptoms and gastric lesions confirmed by re-evaluation through endoscopy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
H&E stain showing cytomegalic inclusions (×400).
Figure 2
Figure 2
Immunohistochemical identification of cytomegalic inclusions (×400).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Cumpacker CS II, Zhang JL. Cytomegalovirus. In: Mandell GL, Bennett JE, Dolin R eds. Mandell, Douglas and Bennett's principles and practice of infectious diseases. 7th edn Philadelphia: Churchill Livingstone Elsevier, 2010;Chapter 138:1971–87.
    1. Jain M, Duggal S, Chugh TD. Cytomegalic infection in non-immunosuppressed critically ill patients. J Infect Dev Ctries 2011;5:571–9. - PubMed
    1. Friel TJ. Epidemiology, clinical manifestations, and treatment of cytomegalovirus in immunocompetent hosts [Internet]. 2014. [updated 13 May 2014; cited 17 Jul 2014]. http://www.uptodate.com
    1. Ljungman P, Griffiths P, Paya C. Definitions of cytomegalovirus infection and disease in transplant recipients. Clin Infect Dis 2002;34:1094–7. 10.1086/339329 - DOI - PubMed
    1. Rafailidis PI, Mourtzoukou EG, Varbobitis IC et al. . Severe cytomegalovirus infection in apparently immunocompetent patients: a systematic review. Virol J 2008;5:47 10.1186/1743-422X-5-47 - DOI - PMC - PubMed

Publication types