| Serology | Quantitative PCR¶ | AntigenemiaΔ | Culture | Histopathology◊ | Resistance testing |
Immunocompetent |
Acute or recent infection | IgM or fourfold increase of IgG | Plasma or whole blood | | | | |
Past infection | IgG | | | | | |
Critically ill | | Plasma or whole blood; consider BAL | | | | |
Immunocompromised |
Assessing risk of CMV disease | IgG | | | | | |
Diagnosis of disease | | | | | | |
Viral syndrome | | Plasma or whole blood | PBMCs | | | |
Pneumonitis | | Plasma or whole blood; consider BAL | PBMCs | BAL or lung tissue | BAL or lung tissue | |
Gastrointestinal disease | | Plasma or whole blood§ | PBMCs§ | Tissue | Tissue | |
Central nervous system disease | | CSF, plasma, whole blood | | | | |
Retinitis | | Vitreous or aqueous fluid | | | | |
Decisions regarding preemptive therapy | | Plasma or whole blood | PBMCs | | | |
Monitoring response to therapy | | Plasma or whole blood | PBMCs | | | |
Treatment failure | | Plasma or whole blood | PBMCs | | | Yes |