胃部巨細胞病毒感染

Gastric Cytomegalovirus Infection

消化道潰瘍出血是臨床常見的問題，其風險因子包括幽門螺旋桿菌感染、非類固醇消炎藥或阿斯匹靈使用、抗凝血藥物使用、病人高齡共病等。雖然巨細胞病毒（cytomegalovirus, CMV）感染引起的上消化道出血較為罕見，但對於反覆或難以治療的病例，應將其納入鑑別診斷。本文為一位81歲男性因雙下肢蜂窩性組織炎住院，治療期間發生反覆大量黑便，經內視鏡檢查和病理切片，確認為CMV感染所致的胃潰瘍。病人經抗病毒藥物ganciclovir治療後病情好轉，後續無再發生出血症狀。對於不明原因的反覆性消化道出血病例，應考慮其他診斷，並及時進行內視鏡檢查與後續治療，以改善預後。

Gastrointestinal ulcer bleeding represents a common clinical condition. Identified risk factors include Helicobacter pylori infection, the use of nonsteroidal anti-inflammatory drugs (NSAIDs) or aspirin, anticoagulant therapy, advanced age, and underlying comorbidities. Although cytomegalovirus (CMV) infection is a rare cause of upper gastrointestinal bleeding, it should be considered in cases of recurrent or refractory bleeding. This report discusses an 81-year-old male hospitalized for bilateral lower limb cellulitis who developed recurrent melena during treatment. Endoscopic examination and pathological analysis confirmed CMV infection-induced gastric ulcers as the underlying cause. The patient responded well to antiviral therapy with ganciclovir, with no recurrence of bleeding symptoms thereafter. This case highlights the importance of considering CMV infection as a differential diagnosis in unexplained recurrent gastrointestinal bleeding. Prompt endoscopic evaluation and antiviral treatment can significantly improve patient outcomes.