CMV pneumonia

Causes and Risks:
Infection with CMV is very common. Eighty percent 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 between 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.

Prevention:
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.

Symptoms:



Signs and Tests:



Treatment:
The objective of treatment is to stop the replication of the virus within the body through the use of antiviral agents Cytovene or Foscarnet. Oxygen therapy and ventilatory support may initially be necessary to maintain oxygenation until the infection is brought under control.

Prognosis:
Antiviral medications stop the replication of the virus but do not destroy it. CMV is in itself immunosuppressive and may worsen the symptoms of other causes of immunosuppression .

Complications:

  • relapse of infection
  • overwhelming infection not responsive to treatment
  • low white blood cell count with use of Cytovene
  • kidney impairment with use of Foscarnet



Call Your Healthcare Provider:
Call your health care provider if symptoms of CMV pneumonia occur.