CMV - pneumonia
Key points
- Cytomegalovirus (CMV) is a member of a group of herpes-type viruses that can cause an infection of the lungs in immune-suppressed persons.
- The majority of healthy adults have antibodies (an indication of previous infection) to CMV in their blood.
- The objective of treatment is to stop the replication of the virus within the body through the use of antiviral agents, such as ganciclovir or foscarnet.
- Antiviral medications stop the replication of the virus, but do not destroy it.
Alternative names
Pneumonia - cytomegalovirus; Cytomegalovirus pneumonia; Troll of transplantation
Definition
Cytomegalovirus (CMV) is a member of a group of herpes-type viruses that can cause an infection of the lungs in immune-suppressed persons. This infection is particularly common in solid organ transplant and bone marrow transplant recipients.
Causes, incidence, and risk factors
Infection with CMV is very common. The majority of healthy adults have antibodies (an indication of previous infection) to CMV in their blood.
Usually CMV produces no symptoms, but serious CMV infections can occur in people with impaired immunity, such as those with AIDS, organ transplant and bone marrow transplant recipients, and people receiving chemotherapy or other immunosuppressive treatments.
CMV disease is a common complication of organ transplantation. CMV pneumonia occurs in 20% of bone marrow transplant recipients. Risk of infection is greatest from 5 to 13 weeks after transplantation.
Complications of CMV infection in individuals with AIDS include: an infectious mononucleosis-like illness (CMV mononucleosis), CMV pneumonia, inflammation of the retina (CMV retinitis), and intestinal disease. In addition, CMV may increase the replication of HIV in infected individuals.
CMV pneumonia is associated with fever, a non-productive cough and shortness of breath (dyspnea). CMV pneumonia is often present simultaneously with pneumocystis pneumonia. Decreased oxygen levels in the blood (hypoxemia) in association with CMV pneumonia often predicts a fatal outcome.
Symptoms
- cough
- shortness of breath
- shortness of breath on exertion
- fever
- general discomfort, uneasiness, or ill feeling (malaise)
- loss of appetite
- fatigue
- sweating, excessive (night sweats)
- muscle aches or joint pains
Signs and tests
- urine culture (clean catch)
- blood culture
- CMV serology by IFA
- bronchoscopy with biopsy, stains, and culture for CMV
- chest X-ray
- arterial blood gas
Treatment
Written and revised by
Andrey Nailor, M.D.
Our doctors write and review articles for accuracy and keep them up to date.
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