Abstract: Cytomegalovirus (CMV) is a prevalent pathogen in the immunocompromised host and invasive pneumonia is a feared complication of the virus in this population. In this pediatric case series we characterized CMV lung infection in 15 non-HIV infected children (median age 3 years; IQR 0.2–4.9 years), using current molecular and imaging diagnostic modalities, in combination with respiratory signs and symptoms. The most prominent clinical and laboratory findings included cough (100%), hypoxemia (100%), diffuse adventitious breath sounds (100%) and increased respiratory effort (93%). All patients had abnormal lung images characterized by ground glass opacity/consolidation in 80% of cases. CMV was detected in the lung either by CMV PCR in bronchoalveolar lavage (82% detection rate) or histology/immunohistochemistry in lung biopsy (100% detection rate). CMV caused respiratory failure in 47% of children infected and the overall mortality rate was 13.3%. Conclusion: CMV pneumonia is a potential lethal disease in non-HIV infected children that requires a high-index of suspicion. Common clinical and radiological patterns such as hypoxemia, diffuse adventitious lung sounds and ground-glass pulmonary opacities may allow early identification of CMV lung infection in the pediatric population, which may lead to prompt initiation of antiviral therapy and better clinical outcomes.
Keywords: CMV; lung; pneumonia; children; ground glass
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Restrepo-Gualteros, S.M.; Jaramillo-Barberi, L.E.; Gonzalez-Santos, M.; Rodriguez-Martinez, C.E.; Perez, G.F.; Gutierrez, M.J.; Nino, G. Characterization of Cytomegalovirus Lung Infection in Non-HIV Infected Children. Viruses 2014, 6, 2038-2051.
Restrepo-Gualteros SM, Jaramillo-Barberi LE, Gonzalez-Santos M, Rodriguez-Martinez CE, Perez GF, Gutierrez MJ, Nino G. Characterization of Cytomegalovirus Lung Infection in Non-HIV Infected Children. Viruses. 2014; 6(5):2038-2051.
Restrepo-Gualteros, Sonia M.; Jaramillo-Barberi, Lina E.; Gonzalez-Santos, Monica; Rodriguez-Martinez, Carlos E.; Perez, Geovanny F.; Gutierrez, Maria J.; Nino, Gustavo. 2014. "Characterization of Cytomegalovirus Lung Infection in Non-HIV Infected Children." Viruses 6, no. 5: 2038-2051.