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Current guidelines for diagnosis and management of CMV in SCT and SOT recipients support the use of either detection of pp65 antigen via immunoassay or quantitative polymerase chain reaction (PCR) for the recognition of CMV infection in serum or bronchoalveolar lavage (BAL).68, 69, 70 There are two accepted strategies for the prevention of CMV disease in transplant recipients: (1) universal prophylaxis in which antivirals are administered to all posttransplantation patients at risk and (2) preemptive therapy in which at-risk patients are monitored for viral replication and antivirals are initiated at a predetermined level of virus replication.68, 69, 71, 72 Intravenous (IV) ganciclovir is recommended for the treatment of severe CMV disease, whereas oral valganciclovir is an alternative in less severe cases.68, 69 HSV disease develops in 35% to 68% of transplant recipients not receiving prophylaxis