A body of literature based largely on serologic assays for the diagnosis of CMV suggests that severe burn injuries are a major risk factor for CMV infection [55, 56] . At least a four-fold rise in serologic titers suggestive of CMV reactivation has been documented in 45 to 56% of the burn patients [19, 21, 22] . Recently, in a study where patients with severe burn injuries comprised a subset of critically ill patients, CMV viremia using PCR was observed in 55% (11/20) of the burn patients [11] . Burn injuries are associated with profound changes in cell-mediated immunity and a predominant Thelper 1 cell response that may facilitate CMV infection [57] [58] [59] . Susceptibility to sepsis due to the loss of skin integrity in these patients may also contribute to the risk of CMV infection.