Searching for a cause of a gastric ulcer in case of common variable immunodeficiency: cytomegalovirus

A 66-year-old man attended our hospital for endoscopic surveillance of a 20 mm gastric antral ulcer. 4 weeks earlier, the patient had presented with haematemesis and melena; a Forrest IB gastric ulcer—active oozing—was found at gastroscopy, and was treated by adrenaline injection, bipolar coagulation, and endoscopic hemoclipping (figure). (A) Photograph taken during endoscopy shows the non-healing gastric antral ulcer. (B) Histopathology of a biopsy specimen shows cytomegalovirus with inclusion bodies (arrows; haematoxylin and eosin stain). Original magnification X600.