Gastrointestinal CMV in an elderly, immunocompetent patient

Area of Science:

• Gastroenterology
• Infectious Diseases
• Virology

Background:

• Cytomegalovirus (CMV) is a common virus typically asymptomatic in immunocompetent hosts.
• Gastrointestinal (GI) manifestations of CMV are rare in immunocompetent individuals, often associated with immunosuppression.

Observation:

• An 83-year-old male with diabetes presented with melena.
• Endoscopic evaluation revealed gastric, duodenal, and colonic ulcers.
• Biopsies confirmed the presence of CMV within the ulcerated tissues.

Findings:

• CMV infection was diagnosed in an otherwise immunocompetent elderly male patient.
• The patient exhibited significant GI ulcerations across multiple segments of the GI tract.
• Histopathological examination of biopsy specimens confirmed CMV inclusion bodies.

Implications:

• This case highlights that CMV can cause severe GI ulceration in immunocompetent individuals, particularly the elderly or those with comorbidities.
• Consideration of antiviral therapy (e.g., ganciclovir) is warranted in immunocompetent patients over 55 or with chronic diseases presenting with unexplained GI ulcers.
• Early diagnosis and treatment of CMV in this population may prevent serious complications.