Morbidity due to donation from a seropositive donor to seronegative recipient is usually higher. CMV interstitial pneumonia is the most common, important and severe infectious complication of the bone marrow transplanted patients. Usually the onset is in the first 120 days after transplantation. The principal finding on chest radiographs is an interstitial nodular infiltrate. Usually CMV results in a rapid onset with fever, nonproductive cough and dyspnea.
Hypoxia can occur in severe illness.
The mortality rate is very high even with antiviral therapy. CMV hepatitis is more common after primary infection, usually arising after transplantation from a seropositive donor. Patients develop fever, hyperbilirubinemia, and elevated liver enzymes. Severe hepatitis can lead to liver failure and another transplantation. Among kidney transplant patients CMV syndrome is common and consists of fever, leukopenia, atypical lymphocytosis, hepatosplenomegaly, myalgia and arthralgia.