Article in Japanese

Gastroduodenal tract cytomegalovirus infection in an immunocompetent 8-month-old girl

Yuu HARAKI^1）, Taizo KUSANO^1）, Taijirou WATANABE^1）, Shota YAMAMOTO^1）, Koo NAGASAWA^1）, Takeshi SAITO^2）, Tadashi HOSHINO^1）

This is a valuable case of CMV gastroduodenitis in an 8-month-old immunocompetent female infant. The child was reported to have experienced a 3-month history of several episodes of vomiting per day. A month prior to presentation, she had developed bloody vomiting which resolved within a few days. The bloody vomiting then re-emerged and she was admitted to hospital for a thorough evaluation. Her physical examination and routine blood test results were normal; however, an upper gastrointestinal endoscopy revealed multiple gastric erosions and extensive erythema, with duodenal bulb ulceration. A histopathological evaluation of a biopsy specimen showed cytomegalic inclusion bodies in the epithelium. Immunohistochemical analysis revealed positive results for cytomegalovirus (CMV), and she was diagnosed with CMV gastroduodenitis. History-taking and examination did not reveal findings suggestive of immunodeficiency. After admission, the vomiting resolved rapidly, and the patient resumed oral intake. She was discharged on the 14^th day after admission. A repeat upper gastrointestinal endoscopy performed 19 days after discharge confirmed resolution of the gastroduodenitis. The patient has been followed up without treatment since that time, and without recurrent symptoms. An accurate diagnosis of CMV gastroduodenitis is based on a histopathological evaluation of endoscopic biopsy specimens; despite the fact that endoscopies are challenging in children.

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1）Department of infectious diseases, Chiba childrenʼs hospital
2）Department of pediatric surgery, Chiba childrenʼs hospital

Key words	immunocompetent child, cytomegalovirus, gastroduodenitis, bloody vomiting, immunohistochemical analysis
Received	December 8, 2022
Accepted	March 9, 2023

35 (2)：129─135,2023