Human cytomegalovirus pneumonia in an immunocompetent patient: a very uncommon but treatable condition

Influenza virus, rhinovirus, and adenovirus frequently cause viral pneumonia, an important cause of morbidity and mortality especially in the extreme ages of life. During the last two decades, three outbreaks of coronavirus-associated pneumonia, namely Severe Acute Respiratory Syndrome, Middle-East Respiratory Syndrome, and the ongoing Coronavirus Infectious Disease—2019 (COVID-19) were reported. The rate of diagnosis of viral pneumonia is increasingly approaching 60% among children identified as having community-acquired pneumonia (CAP). Clinical presentation ranges from mild to severe pneumonitis complicated by respiratory failure in severe cases. The most vulnerable patients, the elderly and those living with cancer, report a relevant mortality rate. No clinical characteristics can be useful to conclusively distinguish the different etiology of viral pneumonia. However, accessory symptoms, such as anosmia or ageusia together with respiratory symptoms suggest COVID-19. An etiologic-based treatment of viral pneumonia is possible in a small percentage of cases only. Neuraminidase inhibitors have been proven to reduce the need for ventilatory support and mortality rate while only a few data support the large-scale use of other antivirals. A low-middle dose of dexamethasone and heparin seems to be effective in COVID-19 patients, but data regarding their possible efficacy in viral pneumonia caused by other viruses are conflicting. In conclusion, viral pneumonia is a relevant cause of CAP, whose interest is increasing due to the current COVID-19 outbreak. To set up a therapeutic approach is difficult because of the low number of active molecules and the conflicting data bearing supportive treatments such as steroids.

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“…Jaundice and abdominal pain were the main extrapulmonary symptoms reported. Interestingly, 2 women were in the peripartum period [ 35 ].…”

Section: Clinical Presentationmentioning

confidence: 99%

Characteristics of viral pneumonia in the COVID-19 era: an update

et al. 2021

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“…CMV pneumonia, on the other hand, is relatively rare and its diagnosis can be a challenge. One should always keep in mind the possibility of viral infections such as CMV in immunocompromised patients and workup should be tailored accordingly [1][2][3][4][5][6][7][8][9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

Who’s the Opportunist? CMV Pneumonia in HIV-Infection-Case Report

Ferreira¹

2022

J Viro Res Rep

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Introduction: The novel coronavirus also called SARS-COV-2 was declared a global pandemic by the WHO in March 2020. In the Republic of Congo, the first imported case was introduced on March 14, 2020. Pointe-Noire, whose 1st case was reported on March 17, 2020, is described as the second epicenter of the disease after Brazzaville the capital. Objective: In this work, the authors described the epidemiological, diagnostic and therapeutic aspects that contributed to the management of COVID-19 patients in Pointe-Noire. Material and Method: This was a cross-sectional descriptive study. The situational analysis was based on the situation report (SITREP) n°: 434 including COVID-19 data from the department of Pointe-Noire since the declaration of the first case until June 19, 2021, a period of 15 months. The biological diagnosis was exclusively based on RT-PCR from a nasopharyngeal swab. The extraction was carried out using two processes: filter column extraction and magnetic ball extraction using different kits. Amplification was performed on five types of PCR instruments.

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“…For maintenance after transplant, a 100 to 120-day course of 5 mg/kg or induction with a 21-day course of valganciclovir 900 mg twice a day and maintenance with 900 mg once per day are recommended [ 11 , 12 , 13 ]. In immunocompetent individuals with CMV pneumonia, valganciclovir 900 mg was administered twice a day for at least 14 days for symptom resolution [ 14 ]. A combination of ganciclovir and IVIG is the recommended therapy for CMV pneumonia in transplant recipients [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus Pneumonia in a Patient with X-Linked Agammaglobulinemia: A Case Report

Wong

Shyur

2022

Medicina

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X-linked agammaglobulinemia (XLA) is a hereditary immune disorder that predisposes patients to frequent and severe bacterial infections caused by encapsulated bacteria (such as Streptococcus pneumoniae, Staphylococcus aureus, and Haemophilus influenzae). Otitis media, sinusitis, and pneumonia are common complications of XLA that require prompt diagnosis and treatment. Cytomegaloviruses (CMV) cause widespread and severe infections in immunocompromised individuals, affecting the respiratory tract, and consequently, leading to pneumonia, which is associated with a high mortality rate. However, CMV-induced pneumonia is rarely reported in patients with XLA. This case study details a 37-year-old male patient with XLA presenting with fever, productive cough, and dyspnea. The patient was diagnosed with CMV pneumonia and recovered after treatment. To the best of our knowledge, this is the first reported case of CMV pneumonia in a patient with XLA in Taiwan. This case study emphasizes that CMV pneumonia in patients with XLA is a treatable condition if diagnosed promptly, and that a shorter duration of treatment with the antiviral agent, in combination with immunoglobulin replacement therapy, can resolve symptoms.

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Human cytomegalovirus pneumonia in an immunocompetent patient: a very uncommon but treatable condition

Cited by 10 publications

References 19 publications

Characteristics of viral pneumonia in the COVID-19 era: an update

Characteristics of viral pneumonia in the COVID-19 era: an update

Who’s the Opportunist? CMV Pneumonia in HIV-Infection-Case Report

Cytomegalovirus Pneumonia in a Patient with X-Linked Agammaglobulinemia: A Case Report

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