The authors have declared that no competing interests exist.
Esophageal ulcer bleeding due to CMV infection is quite infrequent in clinical practice. We reported two cases presenting with different patterns of esophageal ulcer, which was confirmed as CMV esophagitis. Our report would remind physicians the unusual occurrence of the CMV-related esophageal ulcer bleeding in the intensive care unit patients.
Cytomegalovirus (CMV) usually causes opportunistic infections in immunocompromised patients. Active CMV disease occurred in up to 36% of critically ill patients and may affect their health outcomes
A 77-year-old woman with diabetes mellitus and coronary artery disease had short of breath in recent days. Cough with sputum, mild chest tightness, and poor appetite were noted. She was admitted to the ICU and sputum cultures yielded carbapenem-resistant
A 75 y/o man of diabetes and colon cancer post hemicolectomy had received tegafur / uracil chemotherapy. He suffered from nausea, vomiting and hematemesis for one week. The laboratory data showed leukocytosis and panendoscopy revealed pseudomembranous lesions of the esophagus (
CMV diseases have been reported in immunocompromised patients especially with acquired immunodeficiency syndrome and solid organ transplant. Beside, in critically ill patients, CMV infection is associated with prolonged ventilator support, nosocomial infections, prolonged hospital stay and increased mortality
The CMV esophagitis is rarely highlighted in critically ill patients. The most common lesions were well-circumscribed ulcers, usually located in the middle to distal parts of the esophagus
We report two cases of esophageal bleeding lesions, which mucosal pathology confirmed CMV esophagitis. Our cases highlight different endoscopic features of CMV esophagitis among non-immunocompromised and immunocompromised patients in the ICUs. Our report would remind physicians the unusual occurrence of esophageal lesions due to CMV infections.
We declare no conflict of interest and financial support regarding this letter.
The above study has been granted exemption from review by the Institutional Review Board of Chi-Mei Medical Center (IRB Serial No. 10410-005).