CMV pneumonitis history and symptoms
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
History and Symptoms
- CMV is usually asymptomatic in immunocompetent hosts.
- Infected cells characteristically show large intranuclear inclusions with surrounding clearing, smaller cytoplasmic inclusions, and increased cell size.
- CMV causes significant morbidity and mortality in transplant patients, and is the most common infection in lung transplant patients after bacterial pneumonia. CMV negative transplant patients who receive transplants from CMV negative donors usually are unaffected, but CMV positive or negative transplant patients who receive CMV positive or negative kidneys are at significant risk for CMV disease, and prophylaxis is now commonly given with CMV immune globulin or antivirals. Peak onset is 1-4 months post transplant.
- Involvement of most organ systems have been described, but the most common include pneumonitis, colitis, retinitis, hepatitis, pancreatitis, and meningoencephalitis.
- Patients will often present with a mononucleosis-like syndrome with fever/cough, myalgias, fatigue, headache, splenomegaly, and atypical lymphocytosis. Pharyngitis and cervical lymphadenopathy are less common.