Cytomegalovirus Acute Necrotizing Esophagitis

Figure 1A 50-year-old man was admitted with obstructive acute renal failure. In the second week after admission he suffered an episode of upper gastrointestinal bleeding. Emergency upper endoscopy revealed black diffuse mucosa and mucosal bridges resulting from laceration of the submucosal layer in the lower esophagus. Biopsies showed unspecified esophagitis with necrosis. The patient's condition deteriorated and he died with multiple organ failure.

Figure 2The postmortem examination of the esophagus demonstrated multiple inclusion bodies of cytomegalovirus (arrow) in the granulation tissue of the ulcer base, both in the mucosal and muscular layers. HIV serology was negative.