Initial and follow-up endoscopic findings of gastric cytomegalovirus (CMV) infection in an immunocompetent patient. A 79-year-old male visited the gastroenterology clinic due to melena. The initial endoscopy (A, B) showed multiple discrete ulcers at the angle and less curvature of the lower body. The pathologic diagnosis of the initial biopsy was a few atypical glands in the background of chronic active gastritis. The patient was treated using a proton pump inhibitor (PPI) for two months. The first follow-up endoscopy (C) showed improved and healing state ulcers, but the biopsy results revealed a few atypical cells with nuclear inclusion, and CMV immunohistochemical (IHC) staining was positive. The patient received additional PPI treatment for two months. The second follow-up endoscopy (D) showed an ulcer scar, and the biopsy showed chronic gastritis and a negative CMV IHC.

Korean J Gastroenterol 2023;82:269~281 https://doi.org/10.4166/kjg.2023.139