Autopsy studies are the most abundant source of evidence for CMV as a cause of pulmonary disease in HIV-infected patients. In a study of 75 autopsies of patients with HIV infection, 38 of whom were thought to have died of respiratory failure, 44 patients (59 percent) had histologic evidence of CMV infection [ 4 ]. In over one-half of these patients, the CMV was thought to cause little or no pulmonary dysfunction. In contrast, CMV was thought to play some role in 21 of the 44 patients (as a sole pathogen in 6 patients and as a contributory pathogen in 15).
Postperfusion syndrome develops two to four weeks after transfusion with fresh blood containing CMV and is characterized by fever lasting two to three weeks, hepatitis of variable degrees with or without jaundice, a characteristic atypical lymphocytosis (excess of lymph cells in the blood or in any effusion) resembling that of infectious mononucleosis, and occasionally a rash. CMV infection in patients with malignancy or receiving immunosuppressive therapy may cause pulmonary, gastrointestinal or renal (kidney) involvement. This complication is of major importance in some reported transplantation series in which immunosuppressive therapy is utilized.