A silent killer: Cytomegalovirus infection in the nonimmunocompromised critically ill patient

摘要

Eight prospective (11, 19-25) and three retrospective studies (26-28) have been performed in the ICU setting with the specific aim to understand the role of CMV in this nonimunocompro-mised patient population. Table 1 summarizes the main clinical findings of these trials. The findings of sepsis and septic shock as risk factors for CMV infections fit perfectly well with the sepsis/CMV overlapping pro-inflammation/pro-coagulation mechanisms described above. Steroid use as a risk should not be a major revelation because it affects the T-cell response, but I was somewhat surprised by the fact that two of these trials showed higher rate of active CMV infections with low-dose steroids (Table 1).