Table 4.

Definition of Probable Cytomegalovirus (CMV) Syndrome in Solid Organ Transplant Patients Based on Clinical and Laboratory Criteria (at Least 2 Criteria are Required) and Detection of CMV DNA or Antigen in Whole Blood or Plasma Within 1 Week of Symptoms

a. Fever ≥38°C for at least 2 days of which at least 1 measurement is documented in a healthcare setting and without another identified cause of the fever

b. New or increased malaise CTCAE toxicity grade 2, including muscle aches or general achiness, headache, or new or increased fatigue (CTCAE toxicity grade 3)

c. A WBC count of <3500/μL if the WBC count prior to the development of clinical symptoms was ≥ 4000/μL or a WBC decrease of >20% if the WBC count prior to the development of clinical symptoms was <4000/μL; the corresponding neutrophil counts are <1500/μL or a decrease of more than 20% if the neutrophil count before the onset of symptoms was below 1500/μL

d. ≥5% atypical lymphocytes

e. A platelet count of <100 000/μL if the platelet count prior to the development of clinical symptoms was ≥ 115 000/mL or a decrease of >20% if the platelet count prior to the development of clinical symptoms was <115 000/ μL

f. Elevation of hepatic transaminases (alanine aminotransferase or aspartate aminotransferase) to >2 × upper limit of normal or >2×baseline value (if abnormal at baseline); baseline defined as last value before cytomegalovirus viremia was documented (applicable to non-liver transplant recipients)

Abbreviations: CTCAE, National Cancer Institute, Common Terminology Criteria for Adverse Events (version 4.0); WBC, white blood cell.