What intensivists need to know about cytomegalovirus infection in immunocompromised intensive care unit (ICU) patients
Authors' conclusion
CMV infection and disease in critically ill immunocompromised patients pose a unique challenge for intensivists.
Study context
- Population
- Immunocompromised ICU patients (HSCT and solid organ transplantation, solid or hematologic malignancies, HIV infection, immunosuppressive drugs including corticosteroids, primary immunodeficiencies) with cytomegalovirus (CMV) infection or disease
Methodological detailsliterature search in PubMed up to April 2024
- Literature search in PubMed up to April 2024
Main finding
As reported in the abstract
- CMV infection and disease in immunocompromised critically ill patients associated with increased mortality
- Clinical manifestations diverse, shaped by underlying immune deficiency and primary disease; pneumonia and encephalitis among the most severe end-organ diseases
- CMV infection may increase risk of secondary infections and induce life-threatening conditions such as thrombotic microangiopathy
- CMV reactivation is not CMV disease; qPCR of body fluids cannot reliably distinguish viral shedding from tissue-invasive infection, which requires histopathological confirmation
- Ganciclovir commonly first-line; maribavir shows potential for patients unresponsive to other antivirals
- Limited ICU-specific data; many findings extrapolated from general literature
Original publication
What intensivists need to know about cytomegalovirus infection in immunocompromised ICU patients. Intensive Care Med. Published 7 January 2025. doi:10.
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