This case report discusses a rare presentation of cytomegalovirus (CMV) infection in an immunocompetent woman. Typically, CMV is well-studied in immunocompromised individuals, where it can cause severe conditions such as colitis and retinitis. In immunocompetent individuals, it usually causes a mild, mononucleosis-like illness. However, this report details the case of a 30-year-old woman with no significant medical history who developed extensive CMV gastroduodenitis, leading to gastric outlet obstruction.
Key Points:
– The patient, from Karachi, Pakistan, presented with severe vomiting and epigastric pain, along with symptoms indicating gastric outlet obstruction.
– Diagnostic tests revealed a distended stomach and duodenal narrowing, with endoscopy showing severe gastritis and ulcers.
– Biopsy results confirmed CMV infection through characteristic cell inclusions and positive CMV-DNA tests.
– Treatment included a proton pump inhibitor, ganciclovir (an antiviral), and nutritional support via a nasojejunal tube.
– Post-treatment, the patient improved, with follow-up showing some resolution of symptoms and successful pyloric dilation due to its stenosis.
Discussion:
– This case is significant because it demonstrates CMV causing severe gastric issues in an immunocompetent person, a situation rarely reported.
– The case suggests that CMV should be considered in the differential diagnosis for unexplained gastric pathologies, even in patients with normal immune function.
Tawfik, Mark DO1; Chain, Stephanie BS2; Elfiky, Ahmed MD3; Abureesh, Mohammad MD3; Gurala, Dhineshreddy MD3; Andrawes, Sherif MD3; El Douaihy, Youssef MD3. Novel Use of AXIOS Stent for Concurrent Management of Achalasia and Esophageal Varices in a Cirrhotic Patient. ACG Case Reports Journal 11(7):p e01426, July 2024. | DOI: 10.14309/crj.0000000000001426