cytomegalovirus (CMV) pneumonitis

Epidemiology

• occurs in heart & lung transplant recipients
• risk of severe or fatal disease is greatest in CMV mismatched patients, i.e. CMV+ donor, CMV- recipient

Clinical manifestations

• generally occurs 6-12 weeks post transplant when immuno- suppression is maximal
• low-grade fever

Laboratory

• complete blood count (CBC) generally shows leukopenia
• arterial blood gas (ABG) generally shows hypoxemia

Radiology

• chest X-ray generally shows hazy infiltrate

Complications

• active CMV infection predisposes to rejection by upregulation of HLA antigens on the transplanted organ
• bacterial or fungal superinfection
• accelerated transplant vasculopathy

Management

• ganciclovir IV, followed by several months of oral therapy to prevent relapse

Notes

• case report of CMV pneumonitis developing in a 63 year old woman after treatment for newly diagnosed dermatomyositis

More general terms

• pneumonitis
• viral infection

Additional terms

• cytomegalovirus (CMV, human herpesvirus 5, HHV5)