Invasive disease occurs in transplant patients; the worse the transplant immunosuppression, the worse the infection.
Acute respiratory disease and pneumonia (Young adults), Coryza, pharyngitis (Infants), Disseminated infection (Neonates), Epidemic keratoconjunctivitis (Adult), pneumonia with dissemination, urinary tract infection (Immunocompromised), Upper respiratory disease (Children), Central nervous system disease including encephalitis (Immunocompromised), Diarrhea (Children), Hemorrhagic cystitis (Children), Intestinal infection (Immunocompromised), Intussusception (Children), Meningoencephalitis (Children), Pharyngoconjunctival fever (Children). In the transplant patient, viremia without symptoms common, usually progresses in stem cell transplant.
PCR is the way to diagnose.
Who benefits and when to treat is, as always in the transplant patient, uncertain. Cidofovir is better than ganciclovir; lipid complexed cidofovir may be the way to go in the future. Case reports of success with ribavirin and IVIG but everyone gets ribavirin.