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Cytomegalovirus Is Frequently Isolated in Bronchoalveolar Lavage Fluid of Bone Marrow Transplant Recipients without Pneumonia

Petri Ruutu, MD; Tapani Ruutu, MD; Liisa Volin, MD; Pentti Tukiainen, MD; Pentti Ukkonen, MD; and Tapani Hovi, MD
[+] Article, Author, and Disclosure Information

Grant Support: By a grant from the Sigrid Juselius Foundation, Helsinki, Finland.

Requests for Reprints: Petri Ruutu, MD, Second Department of Medicine, Helsinki University Central Hospital, SF-00290 Helsinki, Finland.

Current Author Addresses: Drs. P. Ruutu, T. Ruutu, Volin, and Tukiainen: University of Helsinki, SF-00290 Helsinki, Finland.

Dr. Ukkonen: Department of Pediatrics, Aurora Hospital, SF-00250 Helsinki, Finland.

Dr. Hovi: Department of Virology, National Public Health Institute, SF-00300 Helsinki, Finland.

© 1990 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1990;112(12):913-916. doi:10.7326/0003-4819-112-12-913
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We prospectively studied the presence of cytomegalovirus in bronchoalveolar lavage through virus isolation in 21 bone marrow transplant recipients before and after transplantation. All 14 lavage specimens collected before bone marrow transplantation were negative for cytomegalovirus. During the period from 20 to 90 days after transplantation, 12 of 24 lavage specimens (50%) from 14 patients without lung problems were positive for cytomegalovirus. Cytomegalovirus was isolated from 4 of 10 lavage specimens (40%) in 7 patients with pneumonia during the same interval. We conclude that culture for cytomegalovirus in bronchoalveolar lavage fluid is not a reliable method for establishing the virus's causative role in pneumonia soon after bone marrow transplantation. Among 14 patients in whom bronchoalveolar lavage was done at an asymptomatic stage, 6 of 9 patients with cytomegalovirus and none of 5 without cytomegalovirus in the lavage fluid later developed pneumonia. All of the patients subsequently developing pneumonia also had acute graft-versus-host disease, suggesting an immunopathologic mechanism, possibly triggered by cytomegalovirus, for cytomegalovirus-associated pneumonia.





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