Cytomegalovirus Pneumonitis Presenting Small Nodular Opacities

Shimada, Akiko; Koga, Takeharu; Shimada, Masanari; Kitajima, Takao; Mitsui, Takashi; Sata, Michio; Aizawa, Hisamichi

doi:10.2169/internalmedicine.43.1198

Cited by 10 publications

(4 citation statements)

References 12 publications

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“…83 Although often a diffuse interstitial process on CT, CMV can also present less frequently as nodules or pulmonary consolidations. 84,85 CMV may also present as a copathogen to other major infections, further limiting the specificity of radiologic findings.…”

Section: Radiologymentioning

confidence: 99%

“…102 The fungus Pneumocystis jiroveci can be challenging to distinguish from CMV pneumonia on clinical and radiographic findings alone, and although infrequent, CMV can also present with nodules or consolidation that resembles fungal pneumonia. 84,85 Noninfectious. Noninfectious pulmonary complications can also present with signs and symptoms that may be similar to CMV.…”

Section: Differential Diagnosismentioning

confidence: 99%

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Cytomegalovirus Pneumonia in Hematopoietic Stem Cell Recipients

Travi

Pergam

2013

J Intensive Care Med

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Cytomegalovirus (CMV) is a frequently encountered infection following hematopoietic cell transplantation, and tissue invasive pneumonia is a dreaded complication of the virus in this population. In this review of CMV pneumonia, we address epidemiology, pathogenesis, diagnostics, current therapy and strategies to prevent the development of CMV disease. We also review emerging treatment and prevention options for this challenging disease.

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Section: Radiologymentioning

confidence: 99%

Section: Differential Diagnosismentioning

confidence: 99%

Cytomegalovirus Pneumonia in Hematopoietic Stem Cell Recipients

Travi

Pergam

2013

J Intensive Care Med

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“…Candida species, Cryptococcus), and miliary tuberculosis, among others. 5 Additionally, neoplasia must be considered and excluded in the setting of pulmonary nodules, although in the setting of a rapidly progressive and diffuse process this is much less likely.…”

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus pneumonia presenting as pulmonary nodules

Basinger¹,

Kapp²

2022

Autops Case Rep

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Cytomegalovirus (CMV) pneumonia is a well-known cause of morbidity and mortality in patients with a history of allogenic hematopoietic stem cell transplant. Radiographically, CMV pneumonia most commonly presents as bilateral ground glass opacities; however, the presentation is non-specific and can be variable, including presenting as areas of air-space consolidation or pulmonary nodules. We report a case of a 70-year-old man who presented with rapidly progressive bilateral pulmonary nodules approximately two months after receiving a bone marrow transplant. No infectious etiology was identified for the pulmonary nodules, and a bronchoscopy was unable to be performed due to a rapid decline in the patient's overall condition and respiratory status. The patient died shortly after the decision was made to transition to palliative care and a limited autopsy was performed to explore the pulmonary findings. Corresponding to premortem imaging were the postmortem gross findings of numerous bilateral pulmonary nodules and a large mass-like area of consolidation in the right upper lobe. Microscopic examination of the nodules demonstrated a necrotizing pneumonia with few foci of viral cytopathologic change consistent with CMV, which was confirmed by immunohistochemistry. While CMV is a common infectious agent in the immunocompromised population, CMV pneumonia continues to be a challenging entity due to difficulty in diagnosis and treatment. Rapidly enlarging pulmonary nodules in an immunosuppressed patient is highly suggestive of an infectious process and careful histologic examination for viral cytopathologic change is essential.

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“…Consolidation was seen in 59% and pleural effusion in 22% [15]. The spectrum of HCMV pneumonia may include only cavitary disease, which was recently described in two patients with systemic lupus erythematosus (SLE) treated with steroids [16] or solely small nodular opacities [17]. However, the radiographic findings in HCMV pneumonia are not sufficiently distinct from other viral, bacterial, or fungal infections to differentiate the infectious agent conclusively.…”

Section: Clinical Presentation and Detection Of Hcmv Pneumonitismentioning

confidence: 99%

Pneumonitis in human cytomegalovirus infection

Langhoff

Siegel²

2006

Curr Infect Dis Rep

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Human cytomegalovirus (HCMV) is a beta herpes virus with a double stranded DNA genome of 240kbp. The virus is prevalent and establishes a latent infection in most adults. HCMV is an opportunistic pathogen for patients with impaired cellular immunity. HCMV pneumonia is a common presentation of HCMV disease in immunocompromised patients. The incidence of HCMV pneumonitis can be as high as 90% in lung transplant recipients. This paper takes a fresh look at the challenging perspectives of molecular, immunologic, cellular, diagnostic, clinical, and therapeutic characteristics of HCMV infection as future targets for development of antiviral strategies.

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Cytomegalovirus Pneumonitis Presenting Small Nodular Opacities

Cited by 10 publications

References 12 publications

Cytomegalovirus Pneumonia in Hematopoietic Stem Cell Recipients

Cytomegalovirus Pneumonia in Hematopoietic Stem Cell Recipients

Cytomegalovirus pneumonia presenting as pulmonary nodules

Pneumonitis in human cytomegalovirus infection

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