Cytomegaloviral Pneumonia

CMV pneumonia is characterized by large type A eosinophilic intranuclear/cytoplasmic inclusions. Usually asymptomatic; severe in immunocompromised/infants. Common in bone-marrow/organ transplant and AIDS.

Common Symptoms

Bilateral ground-glass miliary shadows; alveolar hemorrhage; respiratory failure; dyspnea; toxemia; hemoptysis with skin/mucosal bleeding; rales

Causes and Pathogenesis

(1) Etiology: CMV (β-herpesvirus, dsDNA, enveloped); heat-labile (56°C/30 min or 4°C/1 week inactivate). Two antigens: complement-fixing (soluble) and neutralizing (glycoprotein envelope). Strict species specificity; slow growth (2-3 months); enlarged cells with owl's-eye inclusions. (2) Pathogenesis: contact (infants)/sexual (adults); severity depends on viral dose/immunity. Infects epithelial/endothelial/T/B/NK cells; alveolar cells/macrophages; diffuse interstitial edema/fibrosis/alveolar swelling/focal necrosis/hemorrhage → hypoxemia. Cell-mediated immunity key; severe in immunodeficiency (transplant/AIDS).

Treatment

Drug therapy, supportive therapy

Preventive Measures

Donor CMV-negative screening; acyclovir prophylaxis week before and month after; high-titer CMV Ig IV pre-transplant and 2 weeks post, then q3 weeks until day 100.

Department to Visit

It is recommended to visit the Respiratory department; an appointment can be booked on this platform before the visit.

Warm reminder: The above information is for health science reference only and cannot replace professional medical diagnosis. If you have related symptoms, please seek medical attention at a regular hospital promptly.