Lesion: Esophageal ulceration and vasculitis caused by CMV infection at multiple sites

• Biopsy: ≥ 10 specimens from the base of the ulcer. ∆+: Histology identification of CMV by immunohistochemical and direct fluorescence staining

• Blood test : antigen, viral culture, PCR

• Others test: Immunodeficiency, renal failure, malignancy, transplanted organs, HIV, steroid or immunosuppressive therapy

• Treatment: Treatment primary disease: immunodeficiency… Antivirus: Ganciclovir/forcarnet IV, oral Valganciclovir