Analysis of Cytomegalovirus Infection Affecting the Stomach.

Abstract

Background: The incidence of cytomegalovirus (CMV) infection is increasing. This study explored the clinical characteristics, diagnosis, treatments, and prognosis of gastric lesions caused by CMV infection.

Methods: This is a systematic review of the literature on CMV infection involving the stomach.

Results: A total of 39 English publications reporting 44 cases of CMV gastritis were identified through literature retrieval. Clinically, patients with CMV gastritis commonly presented with gastrointestinal symptoms, including abdominal pain, nausea and/or vomiting, and gastrointestinal bleeding. Endoscopic findings most frequently included mucosal ulcers (54.55%), erosions (27.27%), and erythema (20.45%). Most patients had a history of immunosuppression, such as AIDS, postorgan transplantation, cancer chemotherapy, or long-term use of corticosteroids and immunosuppressants. The diagnosis was primarily confirmed by endoscopic biopsy combined with CMV DNA quantitative testing. The majority of patients improved after antiviral therapy, while a small subset experienced spontaneous resolution. However, a few cases (2.27%) progressed to gastric cancer, and some (4.55%) resulted in death.

Conclusion: In patients with a history of immunosuppression presenting with gastrointestinal symptoms such as abdominal pain, nausea, vomiting, or gastrointestinal bleeding, CMV gastritis should be considered in the differential diagnosis. Endoscopic biopsy with histopathological examination plays a crucial role in confirming the diagnosis.