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Cytomegalovirus Pneumonia
Carol C. Wu, MDCarlos S. Restrepo, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Cytomegalovirus (CMV)
            • Synonyms

              • Formerly known as human herpesvirus 5 (HHV-5)
            • Definitions

              • CMV
                • Member of herpesvirus family
                • Variety of disease manifestations
              • CMV pneumonia is serious cause of mortality and morbidity in immunocompromised adults
                • Patients with acquired immunodeficiency syndrome (AIDS)
                • Allogeneic stem cell transplant recipients
                • Solid organ transplant recipients
              • CMV pneumonia
                • Severe viral community-acquired pneumonia in immunocompetent adults
              • Proven CMV pneumonia requires clinical symptoms &/or signs of pneumonia
                • e.g., new airspace disease on imaging, hypoxia, tachypnea, &/or dyspnea
                • CMV documented in lung tissue
                  • Virus isolation
                  • Rapid culture
                  • Histopathology
                  • Immunohistochemistry
                  • DNA hybridization techniques

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • Imaging Recommendations

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • Microscopic Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  Selected References

                                  1. Kose A et al: Cytomegalovirus associated severe pneumonia in three liver transplant recipients. J Infect Dev Ctries. 14(11):1338-43, 2020
                                  2. Kunihiro Y et al: Differential diagnosis of pulmonary infections in immunocompromised patients using high-resolution computed tomography. Eur Radiol. 29(11):6089-99, 2019
                                  3. Restrepo-Gualteros SM et al: Challenges and clinical implications of the diagnosis of cytomegalovirus lung infection in children. Curr Infect Dis Rep. 21(7):24, 2019
                                  4. Koo HJ et al: Radiographic and CT Features of viral pneumonia. Radiographics. 38(3):719-39, 2018
                                  5. Shionoya Y et al: Cytomegalovirus pneumonia with progressive lung volume loss. Am J Case Rep. 19:1393-7, 2018
                                  6. Almaghrabi RS et al: Cytomegalovirus infection in lung transplant recipients. Expert Rev Respir Med. 11(5):377-83, 2017
                                  7. Ljungman P et al: Definitions of cytomegalovirus infection and disease in transplant patients for use in clinical trials. Clin Infect Dis. 64(1):87-91, 2017
                                  8. Kunihiro Y et al: The usefulness of a diagnostic method combining high-resolution CT findings and serum markers for cytomegalovirus pneumonia and pneumocystis pneumonia in non-AIDS patients. Acta Radiol. 56(7):806-13, 2015
                                  9. Omeri AK et al: Comparison of high-resolution computed tomography findings between pseudomonas aeruginosa pneumonia and cytomegalovirus pneumonia. Eur Radiol. 24(12):3251-9, 2014
                                  10. Cunha BA: Cytomegalovirus pneumonia: community-acquired pneumonia in immunocompetent hosts. Infect Dis Clin North Am. 24(1):147-58, 2010
                                  11. Ison MG et al: Cytomegalovirus pneumonia in transplant recipients. Clin Chest Med. 26(4):691-705, viii, 2005
                                  12. Chan KM et al: Infectious pulmonary complications in lung transplant recipients. Semin Respir Infect. 17(4):291-302, 2002
                                  13. Kang EY et al: Cytomegalovirus pneumonia in transplant patients: CT findings. J Comput Assist Tomogr. 20(2):295-9, 1996
                                  14. McGuinness G et al: Cytomegalovirus pneumonitis: spectrum of parenchymal CT findings with pathologic correlation in 21 AIDS patients. Radiology. 192(2):451-9, 1994
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        • Clinical Issues

                                          • Diagnostic Checklist

                                            TERMINOLOGY

                                            • Abbreviations

                                              • Cytomegalovirus (CMV)
                                            • Synonyms

                                              • Formerly known as human herpesvirus 5 (HHV-5)
                                            • Definitions

                                              • CMV
                                                • Member of herpesvirus family
                                                • Variety of disease manifestations
                                              • CMV pneumonia is serious cause of mortality and morbidity in immunocompromised adults
                                                • Patients with acquired immunodeficiency syndrome (AIDS)
                                                • Allogeneic stem cell transplant recipients
                                                • Solid organ transplant recipients
                                              • CMV pneumonia
                                                • Severe viral community-acquired pneumonia in immunocompetent adults
                                              • Proven CMV pneumonia requires clinical symptoms &/or signs of pneumonia
                                                • e.g., new airspace disease on imaging, hypoxia, tachypnea, &/or dyspnea
                                                • CMV documented in lung tissue
                                                  • Virus isolation
                                                  • Rapid culture
                                                  • Histopathology
                                                  • Immunohistochemistry
                                                  • DNA hybridization techniques

                                            IMAGING

                                            • General Features

                                              • Radiographic Findings

                                                • CT Findings

                                                  • Imaging Recommendations

                                                    DIFFERENTIAL DIAGNOSIS

                                                      PATHOLOGY

                                                      • Microscopic Features

                                                        CLINICAL ISSUES

                                                        • Presentation

                                                          • Demographics

                                                            • Natural History & Prognosis

                                                              • Treatment

                                                                DIAGNOSTIC CHECKLIST

                                                                • Consider

                                                                  Selected References

                                                                  1. Kose A et al: Cytomegalovirus associated severe pneumonia in three liver transplant recipients. J Infect Dev Ctries. 14(11):1338-43, 2020
                                                                  2. Kunihiro Y et al: Differential diagnosis of pulmonary infections in immunocompromised patients using high-resolution computed tomography. Eur Radiol. 29(11):6089-99, 2019
                                                                  3. Restrepo-Gualteros SM et al: Challenges and clinical implications of the diagnosis of cytomegalovirus lung infection in children. Curr Infect Dis Rep. 21(7):24, 2019
                                                                  4. Koo HJ et al: Radiographic and CT Features of viral pneumonia. Radiographics. 38(3):719-39, 2018
                                                                  5. Shionoya Y et al: Cytomegalovirus pneumonia with progressive lung volume loss. Am J Case Rep. 19:1393-7, 2018
                                                                  6. Almaghrabi RS et al: Cytomegalovirus infection in lung transplant recipients. Expert Rev Respir Med. 11(5):377-83, 2017
                                                                  7. Ljungman P et al: Definitions of cytomegalovirus infection and disease in transplant patients for use in clinical trials. Clin Infect Dis. 64(1):87-91, 2017
                                                                  8. Kunihiro Y et al: The usefulness of a diagnostic method combining high-resolution CT findings and serum markers for cytomegalovirus pneumonia and pneumocystis pneumonia in non-AIDS patients. Acta Radiol. 56(7):806-13, 2015
                                                                  9. Omeri AK et al: Comparison of high-resolution computed tomography findings between pseudomonas aeruginosa pneumonia and cytomegalovirus pneumonia. Eur Radiol. 24(12):3251-9, 2014
                                                                  10. Cunha BA: Cytomegalovirus pneumonia: community-acquired pneumonia in immunocompetent hosts. Infect Dis Clin North Am. 24(1):147-58, 2010
                                                                  11. Ison MG et al: Cytomegalovirus pneumonia in transplant recipients. Clin Chest Med. 26(4):691-705, viii, 2005
                                                                  12. Chan KM et al: Infectious pulmonary complications in lung transplant recipients. Semin Respir Infect. 17(4):291-302, 2002
                                                                  13. Kang EY et al: Cytomegalovirus pneumonia in transplant patients: CT findings. J Comput Assist Tomogr. 20(2):295-9, 1996
                                                                  14. McGuinness G et al: Cytomegalovirus pneumonitis: spectrum of parenchymal CT findings with pathologic correlation in 21 AIDS patients. Radiology. 192(2):451-9, 1994