Characterization of Cytomegalovirus Lung Infection in Non-HIV Infected Children

Viruses

Sonia M. Restrepo-Gualteros⁵  Lina E. Jaramillo-Barberi¹  Monica Gonzalez-Santos⁴  Carlos E. Rodriguez-Martinez⁴  Geovanny F. Perez²  Maria J. Gutierrez³ 

[1] Department of Pathology, School of Medicine, Universidad Nacional de Colombia, Bogota 111321, Colombia; E-Mail:;Division of Pulmonary and Sleep Medicine, Children’s National Medical Center, Washington, DC 20010, USA; E-Mail:;Division of Pediatric Rheumatology, Allergy and Immunology, Pennsylvania State University College of Medicine, Hershey, PA 17033, USA; E-Mail:;Department of Pediatrics, School of Medicine, Universidad Nacional de Colombia, Bogota 111321, Colombia; E-Mails:;Division of Pediatric Pulmonology, Fundacion Hospital La Misericordia, Bogota 111411, Colombia; E-Mail:

关键词: CMV;    lung;    pneumonia;    children;    ground glass;   

DOI  :  10.3390/v6052038

来源: mdpi

【 摘 要 】

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.

【 授权许可】

CC BY   
© 2014 by the authors; licensee MDPI, Basel, Switzerland.