Acute Hypoxemic Respiratory Failure and Native Lung Idiopathic Pulmonary Fibrosis Exacerbation in Single-lung Transplant Patients with Cytomegalovirus Disease: A Case Series

Transplant Proc. 2019 Dec;51(10):3391-3394. doi: 10.1016/j.transproceed.2019.07.017. Epub 2019 Nov 14.

Abstract

Background: Our case series describes three patients who have received single-lung transplantations for idiopathic pulmonary fibrosis (IPF) that develop cytomegalovirus (CMV) disease and hypoxemic respiratory failure with radiographic opacification of the native lung and sparing of the allograft.

Results: Hypoxemia resolved with treatment and with resolution of CMV viremia. Viral infections causing IPF exacerbations have been described in the literature, however, pulmonary CMV disease in single-lung transplant recipients has typically been observed as pneumonitis of the allograft.

Conclusions: These clinical scenarios are consistent with acute exacerbation of native-lung IPF and subradiographic pneumonitis of the allograft caused by CMV disease.

Publication types

  • Case Reports

MeSH terms

  • Cytomegalovirus
  • Cytomegalovirus Infections / virology*
  • Female
  • Humans
  • Idiopathic Pulmonary Fibrosis / surgery*
  • Idiopathic Pulmonary Fibrosis / virology*
  • Lung Transplantation / adverse effects
  • Male
  • Middle Aged
  • Pneumonia / virology
  • Respiratory Insufficiency / virology*
  • Transplantation, Homologous / adverse effects*