skip to main content

Cytomegalovirus gastritis — ESEGH MCQ

Instant feedback + full explanation. One question, done properly.

HardLuminal GICytomegalovirus gastritisESEGH

A 47-year-old renal transplant recipient taking tacrolimus and mycophenolate develops epigastric pain, fever and odynophagia. Endoscopy shows large shallow gastric ulcers. Biopsies show viral inclusions and immunohistochemistry is positive for cytomegalovirus. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: A — Intravenous ganciclovir with transplant team review of immunosuppression

CMV gastritis in an immunosuppressed transplant recipient requires antiviral therapy such as ganciclovir and coordinated adjustment of immunosuppression. Fluconazole treats Candida rather than CMV. H. pylori therapy alone would not treat viral inclusions. The pearl is that biopsy with viral staining is essential in atypical ulcers in immunosuppressed patients.

Reference: https://www.nice.org.uk/guidance/conditions-and-diseases/digestive-tract-conditions