In Reply: In response to Dr Peppercorn and colleagues, one of the major goals of our study was to determine whether a broad range of causes of critical illness could induce CMV reactivation. Thus, we intentionally included patients from 4 ICUs (cardiac, trauma, burn, and medical) and demonstrated that CMV reactivation occurred in response to each of the insults (myocardial infarction, trauma, burn, or sepsis) associated with their respective ICUs. Despite differences in the incidence, timing, and duration of CMV reactivation by ICU, the finding that such diverse insults could all lead to CMV reactivation is a novel observation.
Limaye AP, Leisenring WM, Boeckh M. Reactivation of Cytomegalovirus Infection in Critically Ill Immunocompetent Patients—Reply. JAMA. 2008;300(20):2367–2368. doi:10.1001/jama.2008.697