Cytomegalovirus esophagitis and gastritis in AIDS

The radiographic features of cytomegalovirus involvement of the upper gastrointestinal tract in four homosexual men with acquired immunodeficiency syndrome (AIDS) are described. Esophageal involvement (three cases) was demonstrated as a localized ulceration or as a more diffuse esophagitis affecting predominantly the distal esophagus. Gastric involvement (two cases) presented as large nodular rugal folds in the fundus or as a circumferentially narrowed antrum deformed by numerous large nodular contour defects. Endoscopy revealed mucosal erosions, serpiginous ulcers, and inflammatory exudate; biopsies documented the presence of typical inclusion bodies in the epithelial and endothelial cells. Although the radiographic findings are nonspecific, the diagnosis of cytomegalovirus esophagitis and gastritis should be suspected when similar abnormalities are present in immunocompromised patients, particularly homosexual men with AIDS.