Cytomegalovirus Pneumonia in Allogeneic Bone Marrow Transplantation

Recent literature suggests that CMV pneumonia is an immunopathologic process. This case report summarizes the clinical course of a patient which supports this hypothesis. The patient is the recipient of an allogeneic BMT who recovered from an episode of CMV pneumonia that occurred about two months after the transplant. Despite recovery from the viral infection, follow-up BALs revealed persistent lymphocytosis in an apparent asymptomatic patient. He subsequently developed BOOP about four months after the initial CMV infection. These observations suggest that the viral infection may have resulted in the activation of the host's cell-mediated response and provides evidence to support the hypothesis that CMV pneumonia is an immune-mediated process. CMV = cytomegalovirus; BMT = bone marrow transplant; GIG = gamma immune globulin; DHPG = dihydroxy-2-propoxymethyl-guanine; BOOP = bronchiolitis obliterans organizing pneumonia; HLA = human leukocyte antigen; GVHD = graft-vs-host disease