Pneumonitis in human cytomegalovirus infection

Abstract

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.

Effects of intrapulmonary viral tropism and cytokine expression on the histological patterns of cytomegalovirus pneumonia

“…Cytomegalovirus (CMV) is a major pathogenic microbe in immunocompromised individuals, and CMV pneumonia (CMVp) is a critical complication because of the high fatality. 1,2 The clinical findings of CMVp have been well documented; 3,4 however, how CMV infection causes pulmonary lesions is not yet well understood.…”

“…On the basis of viral tropism and the expression of TGF-b1, ITGB6, and IL-8, we conclude that CMV-infected pulmonary cells play an important role in the development of diverse CMVp patterns.Key words: chromogenic in situ hybridization, cytomegalovirus pneumonia, double immunostain, integrin b6, interleukin-8, transforming growth factor-b1Cytomegalovirus (CMV) is a major pathogenic microbe in immunocompromised individuals, and CMV pneumonia (CMVp) is a critical complication because of the high fatality. 1,2 The clinical findings of CMVp have been well documented; 3,4 however, how CMV infection causes pulmonary lesions is not yet well understood.Cytomegalovirus pneumonia, a secondary interstitial pneumonia (IP), exhibits various histopathological characteristics, i.e., focal or diffuse interstitial lesions with/without hemorrhage, hyaline membrane, and necrobiosis. 5-7 It has been reported that CMV infects a wide variety of cell types, including pneumocytes, fibroblasts, macrophages, and endothelial cells in the lung.…”

Approach to Imaging Pulmonary Disease in the Immune Compromised Host

“…CMV infection occurs most commonly in the setting of lung transplantation, bone marrow, and other organ transplantation, with rates typically between 53% and 75% but reported as high as 90%. 89,111,112 Clinical presentation includes fever, cough, and hypoxemia. Infection in the setting of immune compromise is likely caused by reactivation of latent infection.…”