The patient's chest x-ray demonstrated bilateral, mostly basilar interstitial infiltrates without pleural effusion. High resolution chest CT demonstrated multiple patchy areas of ground glass opacity throughout both lungs.
Viral pneumonia is sometimes a diagnosis of exclusion.
Absence of sputum production, a relatively benign clinical presentation, normal or only slightly elevated white blood cell count, a lack of response to antibiotic therapy, and a failure to culture pathogenic bacteria might lead one to suspect that a patient may have viral pneumonia. Most people who are exposed to CMV are asymptomatic. Occasionally, symptoms similar to infectious mononucleosis may be present. More serious disease occurs almost exclusively in patients with immunodificiency, lymphoreticular malignancy, or who are receiving immunosuppressant therapy. CMV pneumonia occurs most often in organ transplant recipients.