Characterization of cytomegalovirus lung infection in Non-HIV infected children

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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._2014.pdf (873.9 KB)

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2014

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Viruses, 1999-4915, Vol. 6,Nro.5 2014, p.2038-2051

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MDPI

URI

https://hdl.handle.net/20.500.12495/1742

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https://www.mdpi.com/1999-4915/6/5/2038

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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.

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Keywords

CMV, Lung, Pneumonia, Children, Ground glass

Temáticas

Neumonía
Infecciones por citomegalovirus
Síndromes de inmunodeficiencia

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