In Reply.—I want to thank Dr Medearis for putting the article by Ballard et al in a better historical perspective. He did, indeed, refer to the pulmonary manifestations of cytomegalovirus (CMV) infection in his excellent review published in 1957.
What is new and distinctive in this report, however, is the high frequency (31.3%) of CMV infection among infants in a neonatal intensive care unit, the well-defined "gray baby" syndrome (not described in previous literature), and the strong suspicion that the disease is iatrogenic due to the transfusion of many units of blood given in small amounts. It should also be noted that although there have been scattered reports of CMV pulmonary disease in early infancy, I daresay that very few clinicians, neonatologists included, would think of CMV as the etiologic agent in this syndrome. Thus, I believe that calling attention to this entity serves a most important function both