Related articles: Cytomegalovirus infection (CMV)
Definition
Cytomegalovirus (CMV) is a viral agent belonging to the herpes virus family, which can cause infections with a wide spectrum of severity.
In most cases, the cytomegalovirus causes a syndrome similar to mononucleosis. In infants and immunosuppressed subjects (such as those who have undergone an organ transplant and are on immunosuppressive therapy) a severe, potentially lethal systemic disease may develop.
Infection is contracted through the blood, body fluids (saliva, urine, seminal fluid, vaginal secretions and milk) and transplanted organs. The cytomegalovirus can also be acquired via transplacental (during pregnancy) or perinatal (from mother to newborn during birth).
Most common symptoms and signs *
- Miscarriage
- Asthenia
- Increased transaminases
- Small child for gestational age
- Convulsions
- Abdominal pain
- Ocular pain
- Muscle pains
- Gastrointestinal hemorrhage
- Hepatitis
- Hepatomegaly
- Hydrocephalus
- Hydrops Fetal
- Hearing loss
- Jaundice
- lymphadenitis
- Swollen lymph nodes
- Livedo Reticularis
- Microcephaly
- Fetal death
- odynophagia
- oligohydramnios
- Loss of coordination of movements
- petechiae
- thrombocytopenia
- Narrowing of the visual field
- Rheumatism
- Reduced vision
- Growth delay
- Mental delay
- Nephritic syndrome
- splenomegaly
- Blurred vision
Further indications
Primary and recurrent cytomegalovirus infections are often asymptomatic or produce modest manifestations: fever, asthenia, muscle pain and increased lymph node volume.
A form known as "cytomegalovirus hepatitis" can cause abnormal liver function with elevation of transaminases, atypical lymphocytosis (like mononucleosic) and splenomegaly.
If the infection is the result of a transfusion of cytomegalovirus-containing blood products, a syndrome develops characterized by persistent fever (2-3 weeks) and manifestations similar to CMV hepatitis.
In the terminal phase of AIDS, cytomegalovirus infection can cause retinitis, ulcerative colitis (with abdominal pain and gastro-intestinal haemorrhages) or an esophagitis (with odynophagia).
In immunosuppressed patients, reactivation of the latent virus causes a syndrome involving various organs (lungs, gastro-intestinal tract and central nervous system). In particular, pneumonia, hepatitis, colitis, esophagitis and nephritis can occur.
During pregnancy, especially in the first trimester of gestation, primary infection can cause abortion, prematurity, post-natal death or serious complications, including mental retardation, microcephaly, petechiae, periventricular calcifications, chorioretinitis and extensive fetal liver damage.
Infants who acquire CMV after birth, especially if they are premature, may develop pneumonia, hepatitis, thrombocytopenia, atypical lymphocytosis and sensorineural hearing loss.
Laboratory diagnosis, useful in severe forms, may include culture and serology tests, biopsy and search for antigens or viral nucleic acids.
Treatment with ganciclovir and other antiviral drugs allows the management of the most serious manifestations, in particular cytomegalovirus retinitis.
