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CMV - pneumonia
Alternative namesPneumonia - cytomegalovirus; Cytomegalovirus pneumonia; Troll of transplantation
DefinitionCytomegalovirus (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.
Signs and tests
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. Oxygen therapy and ventilatory support may initially be necessary to maintain oxygenation until the infection is brought under control.
Antiviral medications stop the replication of the virus, but do not destroy it. CMV is, in itself, immunosuppressive and may increase the risk of other infections due to the additive immunosuppression .
Calling your health care provider
Call your health care provider if symptoms of CMV pneumonia occur.
Use of CMV-negative donors for seronegative recipients of organ transplants, use of CMV-negative blood products for transfusion, and CMV-immune globulin in certain patients has shown some preventive effects. Prevention of AIDS avoids opportunistic diseases, including CMV, associated with a damaged or incompetent immune system.
Update Date: 2/3/2004Kenneth Wener, M.D., Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA. Review provided by VeriMed Healthcare Network.
Last updated: Tue, 06 Jan 2009 00:20:03 GMT