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November 24, 1978

Cytomegalovirus: A Not So Innocent Bystander

Author Affiliations

University of Florida Gainesville; Stanford University Stanford, Calif

JAMA. 1978;240(22):2470-2471. doi:10.1001/jama.1978.03290220082028

Cytomegalovirus (CMV) infection has long been known to follow renal and cardiac transplantation, with infection rates ranging from 38% to 96%.1-3 While most patients excrete the virus in the urine or in the throat without symptoms, others suffer a relatively severe febrile illness in the first two to three months after transplantation. Additional patients who ostensibly died of bacterial, fungal, or pneumocystis pneumonia were also found to have CMV in lung tissue at postmortem examination. Thus, it was believed that CMV was a near universal accompaniment of transplantation that was generally benign but that occasionally produced a dramatic and occasionally fatal syndrome of pneumonitis, hepatitis, and leukopenia with or without atypical lymphocytosis.

Now, Chatterjee et al (p 2446) present data suggesting that in renal transplant patients, it is not infection with CMV per se that is important but whether this infection is primary or a reactivation of a latent