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CMV pneumonia
Pneumonia - cytomegalovirus; Cytomegalovirus pneumonia; Viral pneumonia
Cytomegalovirus (CMV) pneumonia is an infection of the lungs that can occur in people who have a suppressed immune system.
Causes
CMV pneumonia is caused by a member of a group of herpes-type viruses. Infection with CMV is very common. Most people are exposed to CMV in their lifetime, but typically only those with weakened immune systems become ill from CMV infection.
Serious CMV infections can occur in people with weakened immune systems as a result of:
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HIV/AIDS
HIV/AIDS
Human immunodeficiency virus (HIV) is the virus that causes AIDS. When a person becomes infected with HIV, the virus attacks and weakens the immune ...
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Bone marrow transplant
Bone marrow transplant
A bone marrow transplant is a procedure to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Bone marrow is the soft, fat...
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Chemotherapy
or other treatments that suppress the immune system
Chemotherapy
The term chemotherapy is used to describe cancer-killing drugs. Chemotherapy may be used to:Cure the cancerShrink the cancerPrevent the cancer from ...
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In people who have had organ and bone marrow transplants, the risk of infection is greatest 5 to 13 weeks after the transplant.
Symptoms
In otherwise healthy people, CMV usually produces no symptoms, or it produces a temporary mononucleosis-type illness. However, those with a weakened immune system can develop serious symptoms. Symptoms may include:
- Cough
-
Fatigue
Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
Read Article Now Book Mark Article - Fever
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General discomfort, uneasiness, or ill feeling (
malaise
)
Malaise
Malaise is a general feeling of discomfort, illness, or lack of well-being.
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- Muscle aches or joint pains
- Shortness of breath
- Sweating, excessive (night sweats)
Exams and Tests
The doctor or nurse will perform a physical exam. In addition, the following tests may be done:
-
Arterial blood gas
Arterial blood gas
Blood gases are a measurement of how much oxygen and carbon dioxide are in your blood. They also determine the acidity (pH) of your blood.
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Blood culture
Blood culture
A blood culture is a laboratory test to check for bacteria or other germs in a blood sample.
Read Article Now Book Mark Article - Blood tests to detect and measure substances specific to CMV infection
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Bronchoscopy
(may include
biopsy
)
Bronchoscopy
Bronchoscopy is a test to view the airways and diagnose lung disease. It may also be used during the treatment of some lung conditions.
ImageRead Article Now Book Mark ArticleBiopsy
A biopsy is the removal of a small piece of tissue for laboratory examination.
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Chest x-ray
Chest x-ray
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
ImageRead Article Now Book Mark Article - CT scan of chest
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Urine culture (clean catch)
Urine culture (clean catch)
A urine culture is a lab test to check for bacteria or other germs in a urine sample. It can be used to check for a urinary tract infection in adults...
ImageRead Article Now Book Mark Article - Sputum gram stain and culture
Treatment
The goal of treatment is to use antiviral drugs to stop the virus from copying itself in the body. Some people with CMV pneumonia need IV (intravenous) medicines. Some people may need oxygen therapy and breathing support with a ventilator to maintain oxygen until the infection is brought under control.
Outlook (Prognosis)
Antiviral drugs stop the virus from copying itself, but do not destroy it. The CMV suppresses the immune system, and may increase your risk of other infections.
Low oxygen levels in the blood in people with CMV pneumonia often predicts death, especially in those who need to be placed on a breathing machine.
Possible Complications
Complications of CMV infection in people with HIV/AIDS include spread of disease to other parts of the body, such as the esophagus, intestine, or eye .
Eye
Cytomegalovirus (CMV) retinitis is a viral infection of the retina of the eye resulting in inflammation.
Complications of CMV pneumonia include:
- Kidney impairment (from drugs used to treat the condition)
-
Low
white blood cell count
(from drugs used to treat the condition)
White blood cell count
A WBC count is a blood test to measure the number of white blood cells (WBCs) in the blood. WBCs help fight infections. They are also called leukocy...
ImageRead Article Now Book Mark Article - Overwhelming infection that doesn't respond to treatment
- Return of CMV infections (may be due to the virus becoming resistant to the antiviral drug)
When to Contact a Medical Professional
Call your health care provider if you have symptoms of CMV pneumonia.
Prevention
The following have been shown to help prevent CMV pneumonia in certain people:
- Using organ transplant donors who don't have CMV
- Using CMV-negative blood products for transfusion
- Using CMV-immune globulin in certain people
Preventing HIV/AIDS avoids certain other diseases, including CMV, that can occur in people who have a weakened immune system.
References
Crothers K, Morris A, Huang L. Pulmonary complications of HIV infection. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 90.
Crumpacker CS. Cytomegalovirus (CMV). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 140.
Madtes DK. Pulmonary complications of stem cell and solid organ transplantation. In: Broaddus VC, Mason RJ, Ernst JD, et al, eds. Murray and Nadel's Textbook of Respiratory Medicine . 6th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 91.
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CMV pneumonia - illustration
Cytomegalovirus is a large herpes-type virus commonly found in humans that can cause serious infections in people with impaired immunity. CMV pneumonia is treated with antiviral medications, which may stop the replication of the virus but will not destroy it.
CMV pneumonia
illustration
-
CMV (cytomegalovirus) - illustration
Cytomegalovirus is a large herpes-type virus commonly found in humans that can cause serious infections in people with impaired immunity. The infection may result in pneumonia, gastroenteritis, retinitis or encephalitis. Antiviral medicines may stop the replication of the virus, but will not destroy it.
CMV (cytomegalovirus)
illustration
-
CMV pneumonia - illustration
Cytomegalovirus is a large herpes-type virus commonly found in humans that can cause serious infections in people with impaired immunity. CMV pneumonia is treated with antiviral medications, which may stop the replication of the virus but will not destroy it.
CMV pneumonia
illustration
-
CMV (cytomegalovirus) - illustration
Cytomegalovirus is a large herpes-type virus commonly found in humans that can cause serious infections in people with impaired immunity. The infection may result in pneumonia, gastroenteritis, retinitis or encephalitis. Antiviral medicines may stop the replication of the virus, but will not destroy it.
CMV (cytomegalovirus)
illustration
Review Date: 12/10/2015
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
