Cardiac Surgery

Infection with CMV following cardiac surgery was first recognized as a syndrome resembling infec­tious mononucleosis, and in most cases, documented infection with CMV in nonimmunosuppressed adults produces little, if any, disease; however, concomitant viral infection may increase susceptibility to and severity of sepsis in patients with bacterial infection. Immunologic disturbances with CMV infection have been demonstrated in vitro, in animals, and in humans.

In particular, natural killer cell activity, T cell prolif­eration to mitogen and antigen, and polymorphonu­clear mobilization and function have been found to be impaired by infection with CMV. Once colonized or infected by bacteria at the time of surgery, the CMV-infected host may be unable to eradicate the infecting organism. Such examples are seen in renal- transplant recipients, where concomitant bacteremia and cytomegaloviremia result in higher morbidity and mortality, and in cardiac-transplant recipients, where bacterial or fungal pulmonary superinfections occur more frequently in patients with active CMV infec­tion; however, no data have been published regard­ing the possible association of CMV infection and bacterial complications occurring after conventional cardiac surgery. The purpose of this study was to determine the incidence of CMV infection in adult patients with mediastinitis, and the possible conse­quences of such infection on morbidity and mortality in such conditions.
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Category: Diseases / Tags: Cardiac Surgery, Cytomegaloviral Infection, incidence, Morbidity

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