Life-threatening gastrointestinal bleeding caused by cytomegalovirus-induced duodenal ulcer in a patient with AIDS： a case report

Abstract Background Diagnosis and treatment for gastrointestinal bleeding among patients with acquired immune deficiency syndrome (AIDS) were challenging. Here we present a rare case of life-threatening gastrointestinal bleeding in an AIDS patient. Case presentation A 31-year-old male with a three-month history of HIV infection was admitted on July 18, 2023, complaining of abdominal pain for over one month and hematochezia for the past twelve days. During his hospitalization, gastrointestinal endoscopy identified the source of bleeding as a duodenal ulcer associated with cytomegalovirus(CMV) infection confirmed through comprehensive determination methods involving metagenomic next-generation sequencing (mNGs), hematoxylin-eosin(HE), and immunohistochemistry (IHC) staining of biopsy tissue from the ulcer. The patient received interventional embolization to manage emergency gastrointestinal bleeding in addition to four-week anti-CMV treatment and remained in stable clinical condition during two months follow-up. Conclusions This case highlights potential complexity of CMV infection in HIV-infected patients with gastrointestinal bleeding.