Cytomegalovirus (CMV) pneumonia

Infection with cytomegalovirus usually occurs in neonates and infants and is acquired during birth from the infected mother. Generally these patients are asymptomatic but occasionally a chronic pneumonia may be seen. In normal hosts a mononucleosis syndrome with fever, fatigue, headache and splenomegaly may be observed. Unlike infection with Epstein Barr virus lymphadenopathy is not typical. Occasionally heterogeneous opacities on chest films suggest pneumonia. In immunocompromised patients, particularly AIDS patients, there has been a large number of suspected patients with CMV pneumonia. However, owing to multiple infections in these patients it is difficult to prove that any radiographic or clinical findings are related solely to viral infection. Similarly identification of CMV in sputum does not mean that pathogenetic changes in the lung are related to CMV infection. In order to diagnose true lung parenchymal abnormalities, viral inclusion bodies must be identified in association with inflammatory change.

Clinically symptoms are nonspecific, with fever, nonproductive cough, and shortness of breath being identified. Radiographically findings attributed by some to CMV pneumonia include diffuse bilateral fine reticulonodular opacities (Fig.1). With more severe disease homogeneous opacities may be identified. In a recent study discrete nodules were identified on chest films and CT scans of patients with CMV pneumonia.

PGO