Life-threatening gastrointestinal bleeding caused by cytomegalovirus-induced duodenal ulcer in a patient with AIDS: A case report
Shihui Song,
Wei Guo,
Shi Zou,
Feng Zhou,
Mingqi Luo,
Li Chen,
Ke Liang
Affiliations
Shihui Song
Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China; Center for AIDS Research, Wuhan University, Wuhan, Hubei Province, China
Wei Guo
Department of Pathology, Wuhan University Taikang Medical School, School of Basic Medical Sciences, Wuhan, Hubei Province, China; Pathology Department, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China
Shi Zou
Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China; Center for AIDS Research, Wuhan University, Wuhan, Hubei Province, China; Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, Hubei Province, China
Feng Zhou
Department of Gastroenterology, Zhongnan Hospital of Wuhan University, Hubei Clinical Center and Key Laboratory for Intestinal and Colorectal Diseases, Wuhan, Hubei Province,China
Mingqi Luo
Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China
Li Chen
Infectious Immunology Department, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology,Wuhan, Hubei Province, China; Corresponding author. Infectious Immunology Department, Wuhan Jinyintan Hospital, Tongji Medical College of Huazhong University of Science and Technology, Wuhan, 430040, China.
Ke Liang
Department of Infectious Diseases, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China; Center for AIDS Research, Wuhan University, Wuhan, Hubei Province, China; Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, Hubei Province, China; Department of Nosocomial Infection Management, Zhongnan Hospital of Wuhan University, Wuhan, Hubei Province, China; Corresponding author. Department of Infectious Diseases, Department of Nosocomial Infection Management, Center of Preventing Mother-to-child Transmission for Infectious Diseases, Zhongnan Hospital of Wuhan University. Wuhan Research Center for Infectious Diseases and Cancer, Chinese Academy of Medical Sciences, Wuhan, 430071, China.
Background: The reasons for gastrointestinal bleeding among patients with acquired immune deficiency syndrome (AIDS) were complex. Here we present an unusual case of life-threatening gastrointestinal bleeding caused by a cytomegalovirus-induced duodenal ulcer in an AIDS patient. Case presentation: A 31-year-old male with AIDS was admitted on July 18, 2023, complaining of abdominal pain for 38 days and intermittent hematochezia for 12 days. During his hospitalization, gastrointestinal endoscopy attributed gastrointestinal bleeding to a giant duodenal ulcer. Furthermore, cytomegalovirus(CMV) infection was confirmed as the reason for the ulcer through metagenomic next-generation sequencing (mNGs), hematoxylin-eosin(HE) staining, and immunohistochemistry (IHC) staining for the biopsy tissue. The patient's gastrointestinal bleeding was stopped by interventional embolization. Following a 4-week course of anti-CMV treatment, the giant duodenal ulcer was cured. Conclusions: For AIDS patients with gastrointestinal bleeding, the CMV-induced gastrointestinal ulcer should be considered. Comprehensive mothods (mNGs, HE staining and IHC staining for biopsy tissue) were benefit for confirmed diagnosis. Beside anti-CMV treatment, the interventional embolization is a choice for hemostasis.
