Question
A 45-year-old man with colon cancer is treated with chemotherapy. Two months later, he develops increasing cough and respiratory distress. A chest X-ray shows diffuse bilateral interstitial infiltrates. Sputum cultures are negative, and the patient does not respond to antibiotic therapy. A lung biopsy reveals acute and chronic interstitial pneumonitis. There are enlarged cells with prominent, dark-blue nuclear inclusions as shown in the image). Which of the following is most likely responsible for this patient’s pulmonary condition?
| A. |
Cytomegalovirus
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| B. |
Herpes simplex virus
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| C. |
Epstein-Barr virus
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| D. |
Pneumocystis jiroveci
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Show Answer
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Correct Answer � A
Explanation
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Answer: A Cytomegalovirus
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CMV infection induces interstitial pneumonia in infants and immunocompromised persons.
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Infected alveolar cells show cytomegaly and display a single, dark basophilic nuclear inclusion surrounded by a halo.
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The virus may be transmitted from mother to child in utero or acquired during delivery.
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In adults, CMV is transmitted through sexual encounters, blood transfusions,transplantation, and even through the inhalation of infectious viral particles.
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Central nervous symptoms predominate in symptomatic infants and children.
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In adults, the virus produces mostly respiratory and gastrointestinal symptoms but does not cause encephalitis. Herpes simplex virus also features intranuclear inclusions (also surrounded by a clear halo) but does not cause chronic interstitial pneumonia.
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