Cytomegalovirus pneumonia in a renal transplant patient

Case contributed by Prof Oliver Hennessy

Presentation

Fevers for 2 weeks. Increasing SPB over the same period. Renal transplant recipient, immunosuppressed.

Patient Data

Age: 65
Gender: Male

Multiple small ill-defined nodules in both lungs. There are changes of air space opacification and consolidation present. There are features of extensive tree-in-bud also in both lungs. Bronchiectatic changes are noted bilaterally. There is no mediastinal or pleural abnormality.

The findings are those of an infective process: TB and atypical mycobacteria , fungal and a viral aetiology as well as PCP should be included in the differential diagnosis

Case Discussion

Microbiology post bronchoscopy was positive for cytomegalovirus infection. No TB or atypical mycobacteria was isolated, with no evidence of PCP seen in the bronchial washing specimens.

The typical findings seen in CMV pneumonitis on CT are:

  • multiple nodules
  • areas of peripheral consolidation predominantly involving the lung bases
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Case Information

rID: 33337
Case created: 8th Jan 2015
Last edited: 8th Sep 2015
System: Chest
Inclusion in quiz mode: Included

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