Gastroduodenal Sarcoidosis With Concomitant Cytomegalovirus Gastritis

Gastrointestinal sarcoidosis in the absence of pulmonary disease is rare. Likewise, cytomegalovirus (CMV) reactivation in the stomach is also rare. We present a 67-year-old woman with symptomatic CMV gastritis and gastroduodenal sarcoidosis who presented with epigastric pain, nausea, and vomiting. Initial gastric biopsies revealed CMV gastritis. Repeat assessment demonstrated worsening disease requiring antiviral treatment. After this, further investigations into ongoing epigastric pain demonstrated noncaseating granulomas on repeat gastrointestinal biopsies. A diagnosis of sarcoidosis was established and treated with prednisone to resolution.