Cytomegalovirus gastritis in a patient with severe acute respiratory syndrome coronavirus 2 infection: A case report and literature review

Cytomegalovirus Gastritis Mimicking a Gastroesophageal Junction Malignancy in an AIDS Patient: A Case Report

Cytomegalovirus (CMV) gastritis is a rare opportunistic infection that often affects immunosuppressed patients. It is a DNA virus belonging to the Herpes family most commonly spread through contaminated bodily fluids such as blood, urine, saliva, tears, breast milk, semen, and vaginal fluids. Here, we present a case of a newly diagnosed HIV-positive patient with acquired immunodeficiency syndrome (AIDS) found to have a gastroesophageal (GE) junction ulceration with endoscopic characteristics suggestive of malignancy due to CMV gastritis in the absence of underlying malignancy. Most immunocompetent patients experience mild or no symptomatology and thus often require no treatment. On the contrary, immunosuppressed patients may be greatly affected by CMV including death. Because of this, it is necessary to treat and potentially prophylax against CMV within this population depending on the severity of immunocompromise and overall clinical suspicion. The most common treatments include ganciclovir, valganciclovir, cidofovir, and foscarnet. This case highlights the rare location and endoscopic appearance of CMV gastritis. Since the endoscopic appearance of CMV is highly variable, immunohistochemistry of biopsied mucosa is the only reliable method to correctly diagnose. In addition, this case illustrates the importance of maintaining a broad differential including rare and treatable diseases. Lastly, it summarizes the observed association of CMV ulcers at the GE junction with underlying malignancy reported in the literature.

SARS-CoV-2 and gastrointestinal diseases

BACKGROUND

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is the causative agent of the novel coronavirus disease (COVID-19) pandemic, which has caused serious challenges for public health systems worldwide.

LITERATURE REVIEW

SARS-CoV-2 invades not only the respiratory system, but also the digestive system, causing a variety of gastrointestinal diseases.

SIGNIFICANCE

Understanding the gastrointestinal diseases caused by SARS-CoV-2, and the damage mechanisms of SARS-CoV-2 to the gastrointestinal tracts and gastrointestinal glands are crucial to treating the gastrointestinal diseases caused by SARS-CoV-2.

CONCLUSION

This review summarizes the gastrointestinal diseases caused by SARS-CoV-2, including gastrointestinal inflammatory disorders, gastrointestinal ulcer diseases, gastrointestinal bleeding, and gastrointestinal thrombotic diseases, etc. Furthermore, the mechanisms of gastrointestinal injury induced by SARS-COV-2 were analyzed and summarized, and the suggestions for drug prevention and treatment were put forward for the reference of clinical workers.