Retinitis: A Manifestation of Primary or Secondary Cytomegalovirus Infection?

To the Editor.—  In the report in the August 1977 Archives (137:1026-1029) of cytomegalovirus (CMV) infections, Suwansirikul et al raise the question of whether uncommon but serious organ involvement, such as pneumonitis, encephalitis, and retinitis are manifestations of primary or secondary (reactivation-type) CMV infection. Having recently reviewed CMV retinitis,¹ I re-reviewed the 22 reported cases, which occurred in 18 patients with renal transplants, one patient with breast cancer, one patient with Hodgkin's disease, and two healthy persons with no predisposition, with this question in mind.Adequate clinical and serological details were available for only seven patients (five transplant recipients, the patient with breast cancer, and one healthy patient) two of whom we reported.¹ Only one of these seven probably fulfilled the serological definition proposed by Suwansirikul et al for a primary infection; that is, a pretransplant CMV complement fixation (CF) titer had been obtained (<1:8) and later rose