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When polymerase chain reaction does not help: cytomegalovirus pneumonitis associated with very low or undetectable viral load in both blood and bronchoalveolar lavage samples after lung transplantation
Author(s) -
Coussement J.,
Steensels D.,
Nollevaux M.C.,
Bogaerts P.,
Dumonceaux M.,
Delaere B.,
Froidure A.
Publication year - 2016
Publication title -
transplant infectious disease
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.69
H-Index - 67
eISSN - 1399-3062
pISSN - 1398-2273
DOI - 10.1111/tid.12515
Subject(s) - bronchoalveolar lavage , medicine , pneumonitis , cytomegalovirus , viral load , immunology , ganciclovir , lung , lung transplantation , transplantation , polymerase chain reaction , pathology , human cytomegalovirus , virus , herpesviridae , virology , viral disease , biology , biochemistry , gene
Abstract Cytomegalovirus ( CMV ) pneumonitis occurs frequently among solid organ transplant recipients and is classically associated with significant viral replication in both blood and bronchoalveolar lavage ( BAL ) samples. We present a case of a 64‐year‐old lung transplant recipient who presented with CMV pneumonitis that was diagnosed based on the association of viral inclusion in the BAL sample, rapid response to ganciclovir, and absence of other infectious etiology. Surprisingly, we observed very low or undetectable viral load both in blood and BAL samples. Diagnosis of CMV pneumonitis should rely on the association of clinical, pathological, radiological, and microbiological signs, while quantitative nucleic acid amplification testing should be interpreted with caution.