A Case of duodenitis associated with cytomegalovirus infection in the cirrhotic patient

A 58-year-old man with hepatitis-C-virus-related and alcoholic cirrhosis was admitted to our hospital with fever and abdominal distension. The laboratory data showed his liver functions had been gotten worse than before. Abdominal CT scan showed his duodenum was swelling and ascites was appeared. Upper gastrointestinal endoscopy revealed multiple erosions in the second portion of the duodenum. And also, similar erosions were in his transverse colon and rectum by colonoscopy. Serological tests was positive IgM antibody to cytomegalovirus (CMV) and CMV antigenemia was positive. Biopsy specimen from the duodenum and colon showed the presence of intranuclear inclusion bodies and CMV was demonstrated in biopsy specimen by immunocytochemistry using monoclonal antibody against CMV antigen. He was recovered with antiviral agents for 14days and upper gastrointestinal endoscopy performed 1 month after showed normal duodenal mucosa. CMV associated lesions in the duodenum are rare, especially in a patient with cirrhosis, but some literature said cirrhosis was considered at risk of CMV infection.