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CMV pneumonitis

Suleiman Al-Hammadi, Ahmed R Alsuwaidi, Eman T Alshamsi, Ghassan A Ghatasheh, Abdul-Kader Souid
BACKGROUND: The Bacillus Calmette-Guérin (BCG) preparations are live-attenuated derivatives of Mycobacterium bovis. These products are used to vaccinate infants at birth, a practice that may result in a disseminated infection in those patients who have an unidentified immunodeficiency. CASE PRESENTATION: Patients who were immunized at birth with BCG and who developed a disseminated infection are reported here to emphasize the importance of taking an extensive medical history before ‎giving the BCG vaccine...
May 5, 2017: BMC Research Notes
Kiyohiko Hotta, Yuichiro Fukasawa, Yoshiki Wada, Nobuyuki Fukuzawa, Toshimori Seki, Hiroshi Harada
Among organ transplant recipients, cytomegalovirus (CMV) commonly results in various types of infection such as pneumonitis, hepatitis, and enterocolitis. However, CMV peritonitis is very rare and difficult to diagnose owing to lack of visible clinical signs. We present a case of a 35-year-old female kidney recipient who developed abdominal pain and urinary retention caused by CMV peritonitis. To our knowledge, this is the first case report of CMV peritonitis after organ transplantation to be diagnosed through histopathological examination...
April 19, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Maria M Cuadrado, Asia Ahmed, Ben Carpenter, Jeremy S Brown
We present five cases of cytomegalovirus (CMV) pneumonitis occurring in patients after recent T cell deplete allogeneic stem cell transplantation (AlloHSCT). These cases were complicated by an organising pneumonia (during the recovery period) with a predominantly central peribronchial pattern. All patients presented with evidence of active CMV pneumonitis which was treated successfully with anti-viral therapy but was followed by persistent severe dyspnoea, cough and hypoxia. High resolution computed tomography (HRCT) imaging showed widespread central peribronchial consolidation with traction bronchiectasis...
2017: Respiratory Medicine Case Reports
Kerusha Govender, Prakash Jeena, Raveen Parboosing
Cytomegalovirus (CMV) pneumonitis is a significant cause of morbidity and mortality of children in Africa. The current practice for diagnosing CMV pneumonitis in this setting is based on interpretation of clinical, laboratory, and radiological findings. There is a need for a sensitive and specific laboratory test to objectively distinguish between patients with CMV pneumonitis and those with CMV infection, and non-CMV pneumonia. In this study, we compared plasma and non-bronchoscopic bronchoalveolar lavage (NBBAL) CMV viral loads in patients with CMV pneumonitis and those with CMV infection and non-CMV pneumonia...
June 2017: Journal of Medical Virology
Li-Hong Ran, Lei Bao
Breast milk is considered ideal food for premature infants, but it can also be the main source of cytomegalovirus (CMV) infection in premature infants. CMV infection may cause serious clinical symptoms, such as sepsis-like syndrome, thrombocytopenia, neutropenia, jaundice, hepatitis, and pneumonitis. This article reviews the research advances in symptoms, treatment strategies, prognosis and the prevention of breast milk-acquired CMV infection in premature infants.
October 2016: Zhongguo Dang Dai Er Ke za Zhi, Chinese Journal of Contemporary Pediatrics
Helene Ladefoged Grønborg, Sanne Jespersen, Bo Langhoff Hønge, Søren Jensen-Fangel, Christian Wejse
BACKGROUND: Cytomegalovirus (CMV) infection among HIV-infected individuals may cause end-organ disease, which is an AIDS-defining condition. Evidence from high-income countries suggests that CMV may alter the outcome of HIV infection, other than causing end-organ diseases. We reviewed literature on HIV and CMV coinfection in Africa. METHODS: Systematic review of published studies on HIV and CMV coinfection in Africa using the PubMed database. RESULTS: High CMV seroprevalence was found throughout Africa, exceeding 90% in most populations...
January 2017: Reviews in Medical Virology
Safa Baris, Fayhan Alroqi, Ayca Kiykim, Elif Karakoc-Aydiner, Ismail Ogulur, Ahmet Ozen, Louis-Marie Charbonnier, Mustafa Bakır, Kaan Boztug, Talal A Chatila, Isil B Barlan
PURPOSE: Loss and gain-of-function (GOF) mutations in human signal transducer and activator of transcription 1 (STAT1) lead to distinct phenotypes. Although recurrent infections are common to both types of STAT1 mutations, GOF mutations are distinguished by chronic mucocutaneous candidiasis and autoimmunity. However, the clinical spectra of STAT1 GOF mutations continue to expand. We here describe two patients with STAT1 GOF mutations presenting early in life with combined immunodeficiency (CID)...
October 2016: Journal of Clinical Immunology
Gang Liu, Qiuli Zhang, Wei Wang
Preterm infants (<32 weeks), who are unable to breastfeed, are fed with expressed maternal milk via a nasogastric tube. Mothers of these infants often experience difficulties in establishing and maintaining lactation. The majority of women excrete cytomegalovirus (CMV) in their breast milk. CMV transmitted through maternal milk could cause symptomatic infection in preterm infants presenting as a sepsis like syndrome, pneumonitis, hepatopathy or enterocolitis. Routine freezing of maternal milk decreases the CMV load in breast milk and is used in some neonatal centers to reduce CMV transmission to preterm infants...
February 2017: Minerva Pediatrica
Eva Königshausen, Hartmut Hengel, Ortwin Adams, Heinz Bry, Stephan Steiner, Christina Priegnitz, Anita Hansen, Lorenz Sellin, Lars C Rump, Adina Voiculescu
BACKGROUND: In renal transplant patients, pneumonitis may be caused by cytomegalovirus (CMV pneumonitis). This condition is usually accompanied by CMV viremia. However, CMV may also reactivate locally in the lungs of renal transplant patients with pneumonitis due to other pathogens. The impact of local CMV replication/reactivation in the lungs is unknown. MATERIAL AND METHODS: All renal transplant patients at the Duesseldorf transplant center in the time from 01/2004 to 1/2008 were analyzed concerning pulmonary CMV replication in the setting of pneumonitis...
April 21, 2016: Annals of Transplantation: Quarterly of the Polish Transplantation Society
J Coussement, D Steensels, M-C Nollevaux, P Bogaerts, M Dumonceaux, B Delaere, A Froidure
Cytomegalovirus (CMV) pneumonitis occurs frequently among solid organ transplant recipients and is classically associated with significant viral replication in both blood and bronchoalveolar lavage (BAL) samples. We present a case of a 64-year-old lung transplant recipient who presented with CMV pneumonitis that was diagnosed based on the association of viral inclusion in the BAL sample, rapid response to ganciclovir, and absence of other infectious etiology. Surprisingly, we observed very low or undetectable viral load both in blood and BAL samples...
April 2016: Transplant Infectious Disease: An Official Journal of the Transplantation Society
Uwe Schulz, Paolo Solidoro, Veronika Müller, Attila Szabo, Jens Gottlieb, Heinrike Wilkens, Frank Enseleit
Intravenous ganciclovir and, increasingly, oral valganciclovir are now considered the mainstay of treatment for cytomegalovirus (CMV) infection or CMV disease. Under certain circumstances, CMV immunoglobulin (CMVIG) may be an appropriate addition or, indeed, alternative. Data on monotherapy with CMVIG are limited, but encouraging, for example in cases of ganciclovir intolerance. In cases of recurrent CMV in thoracic transplant patients after a disease- and drug-free period, adjunctive CMVIG can be considered in patients with hypogammaglobulinemia...
March 2016: Transplantation
Susanna K Tan, Elizabeth B Burgener, Jesse J Waggoner, Kiran Gajurel, Sarah Gonzalez, Sharon F Chen, Benjamin A Pinsky
Background.  Cytomegalovirus (CMV) is a major cause of morbidity and mortality in immunocompromised patients, with CMV pneumonitis among the most severe manifestations of infection. Although bronchoalveolar lavage (BAL) samples are frequently tested for CMV, the clinical utility of such testing remains uncertain. Methods.  Retrospective analysis of adult patients undergoing BAL testing via CMV polymerase chain reaction (PCR), shell vial culture, and conventional viral culture between August 2008 and May 2011 was performed...
January 2016: Open Forum Infectious Diseases
Heinrike Wilkens, Martina Sester
Cytomegalovirus (CMV) infection after lung transplantation is associated with increased risk for pneumonitis and bronchiolitis obliterans as well as allograft rejection and opportunistic infections. Ganciclovir is the mainstay of prophylaxis and treatment but CMV infections can be unresponsive. Apart from direct antiviral drugs, CMV immunoglobulin (CMVIG) preparations may be considered but are only licensed for prophylaxis. A CMV-seronegative 42-year-old man with cystic fibrosis received a lung from a CMV-seropositive donor...
2016: Case Reports in Transplantation
Matthew S Kelly, Daniel K Benjamin, Karen M Puopolo, Matthew M Laughon, Reese H Clark, Sagori Mukhopadhyay, Daniel K Benjamin, P Brian Smith, Sallie R Permar
IMPORTANCE: Postnatally acquired cytomegalovirus (CMV) is typically benign in term infants but in very low-birth-weight (VLBW) infants can cause pneumonitis and sepsislike illness. Whether postnatal CMV infection results in long-term pulmonary sequelae in these infants is unknown. OBJECTIVE: To investigate the association between postnatal CMV infection and bronchopulmonary dysplasia (BPD) and mortality in a large multicenter cohort of VLBW infants. DESIGN, SETTING, AND PARTICIPANTS: Conducted between October 2014 and June 2015, this propensity-matched retrospective cohort study involved 101,111 hospitalized VLBW (<1500 g) infants at 348 neonatal intensive care units in the United States from 1997 to 2012...
December 2015: JAMA Pediatrics
Cristina Lopez Garcia-Gallo, Christian García Fadul, Rosalia Laporta, Francisca Portero, Isabel Millan, Piedad Ussetti
BACKGROUND: Evidence concerning the effectiveness of anti-cytomegalovirus immunoglobulin (CMVIg) following lung transplantation in the era of new antiviral agents is limited and controversial. MATERIAL AND METHODS: At-risk patients (donor seropositive/recipient seronegative [D+/R-] and R+) received valganciclovir for 3 months (R+) or 6 months (D+/R). CMVIg (2 mg/kg) was given to D+/R- patients on days 1, 4, 8, 15, and 30 post-transplant, then monthly for a further year...
November 5, 2015: Annals of Transplantation: Quarterly of the Polish Transplantation Society
Jhong-Lin Wu, Hsuan-Yin Ma, Chun-Yi Lu, Jong-Min Chen, Ping-Ing Lee, Shiann-Tarng Jou, Yung-Lin Yang, Hsiu-Hao Chang, Meng-Yao Lu, Luan-Ying Chang, Li-Min Huang
BACKGROUND: Cytomegalovirus (CMV) is a major pathogen causing significant mortality and morbidity in immunocompromised hosts. It is important to find risk factors associated with CMV viremia and its outcome. METHODS: We investigated the incidence, time of onset, risk factors for CMV viremia, and characteristics of CMV diseases in 57 pediatric patients receiving hematopoietic stem cell transplantation (HSCT). Between August 2011 and March 2014, cases of pediatric HSCT patients at the National Taiwan University Children's Hospital were reviewed...
August 14, 2015: Journal of Microbiology, Immunology, and Infection, Wei Mian Yu Gan Ran za Zhi
Juthaporn Cowan, D W Cameron, Greg Knoll, Jason Tay
INTRODUCTION: Haematopoietic stem cell transplantation (HSCT) is commonly employed in the management of haematological malignancies. This intervention results in an increased risk of infectious and immune-related complications. Prophylactic immunoglobulin therapy has been used to prevent post-HSCT complications, including infections, with varying efficacy. We sought to update the current evidence supporting the use of immunoglobulins in the modern HSCT era. METHODS/ANALYSIS: Using a structured search strategy, we will perform a systematic review of the literature from MEDLINE, EMBASE and all EBM Reviews databases...
2015: BMJ Open
Pali D Shah, Qiong Zhong, Elizabeth A Lendermon, Matthew R Pipeling, John F McDyer
Cytomegalovirus (CMV) is a significant cause of morbidity and mortality in immunocompromised hosts, many of whom undergo significant periods of lymphopenia. However, the impact of lymphopenia and subsequent immune reconstitution on T cell responses and pulmonary pathology are poorly understood. Using a model of primary murine CMV infection in mice treated with cyclophosphamide (CY), the relationship of CD8+ T cell reconstitution to pneumonitis pathology was studied. Female BALB/c mice were infected with murine CMV (MCMV) with/without CY on day 1 post-infection...
June 2015: Viral Immunology
Carlos A Q Santos, Daniel C Brennan, Roger D Yusen, Margaret A Olsen
BACKGROUND: Cytomegalovirus (CMV) replication and disease commonly occur in lung transplant recipients after stopping anti-CMV prophylaxis. The epidemiology of CMV disease is not well studied, given the difficulties in assembling representative study populations with prolonged follow-up. We hypothesized that delayed-onset CMV disease (>100 days after transplantation) occurs more commonly than early-onset CMV disease in lung transplant recipients, and is associated with an increased risk of death...
August 2015: Transplantation
M Milinkovic, S Jovicic-Pavlovic, M Lausevic, O Durutovic, R Naumovic
Immunosuppression after transplantation renders the transplant recipient susceptible to a broad array of viral pathogens. Of 31 patients transplanted during 2012 in our center, 6 (19.3%) experienced varicella zoster virus (VZV) reactivation. The median time from transplantation to reactivation was 6.2 months. Immunosuppression consisted of antithymocyte globulin in 5 patients and basiliximab in 1, followed by tacrolimus, mycophenolic acid, and prednisolone. Two patients had T-cell-mediated rejection and were treated with pulse doses of corticosteroids...
January 2015: Transplantation Proceedings
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