Cytomegalovirus

Diagnostics

Symptoms of cytomegalovirus

Treatment

Forecast

Types of cytomegalovirus infection

Causes and mechanisms of development

Cytomegalovirus infection (cytomegaly) is a definite change in the body caused by cytomegalovirus that occurs during critical periods of life – during pregnancy, with immunodeficiency, in early infancy.

In adulthood, in practically healthy people, cytomegaly can last for a long time in a latent form, and the virus can stay in the body for a long time without manifesting itself clinically.

Diagnostics

The basis of the diagnosis is the laboratory detection of cytomegalovirus or antibodies to it in the blood.

Usually used to determine the level of antibodies class   IgM   and   Igg   (Anti-CMV-IgM and Anti-CMV-IgG).

  • If immunoglobulins of class M (IgM antibodies are positive) are detected in the blood, this indicates an active infection and a fresh cytomegalovirus infection that occurred in the next 2-3 weeks.
  • The presence of only immunoglobulin G (IgG antibodies are positive) in the blood indicates the presence of cytomegalovirus in the body in the inactive phase – this is carriage without activating the infection.
  • The appearance of an increasing amount of immunoglobulin G (IgG class antibodies) in the blood indicates the activation of immunity and the formation of the immune response in the body.
  • If there are both classes of immunoglobulins IgM and IgG in the blood, this is an infection that developed about a month ago or a chronic active infection (like congenital cytomegaly, infection in people with immunodeficiency).

Symptoms of cytomegalovirus

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CMV infection in adults

Infection with cytomegalovirus in adults can occur under the guise of a persistent cold, and there can be a long runny nose and malaise, weakness, headaches and pain in the joints, an increase in the salivary glands and lymph nodes.

Most often, the process of infection occurs almost unnoticed by humans.

In general, the severity of the disease will directly depend on the state of the immune system – the course can be from completely asymptomatic to severe generalized infection.

Cytomegalovirus in children

With congenital CMV infection in newborns

  • skin rashes can occur in the form of small hemorrhages,
  • maybe either   prematurity or intrauterine growth retardation of the baby,
  • severe jaundice may occur immediately after birth,
  • the development of chorioretinitis (inflammation of the retina and choroid),
  • the condition can be severe with a mortality rate of up to 30%.

Children with congenital cytomegaly experience mental retardation or vision and hearing problems.

In premature babies, acquired cytomegalovirus infection gives symptoms of prolonged   pneumonia , due to the addition of a microbial infection. There may be a slowdown in physical development, manifestations of hepatitis, rashes or swollen lymph nodes.

Occasionally, in older children, CMV infection produces manifestations similar to   mononucleosis . There are manifestations of persistent cold with sore throat, prolonged fever, chills and headaches, pain in the joints and muscles, enlarged lymph nodes and the region of the salivary glands.There may be a rash on the skin, similar to   rubella. Sometimes it can occur   jaundice   or a change in liver enzyme activity. Often there are complications with the development of pneumonia, but usually it proceeds mildly, sometimes emerging only on x-rays.

Treatment

The presence of a virus in the blood does not require any treatment, since it is not dangerous in an inactive state in healthy people.

In the presence of clinical manifestations or in pregnant high-risk groups, immunomodulating therapy is performed – Viferon and Genferon suppositories.

When the infection is activated, drugs of ganciclovir or acyclovir are shown, but it is used strictly under the supervision of a physician and blood tests due to the presence of numerous side effects.

In case of HIV infection, cytomegalovirus is treated with foscarnet, but only in the hospital and under the control of blood electrolytes and blood composition. The drug is selected in individual dosages.

Forecast

Cure for cytomegalovirus has not yet been described, the virus circulates for life in the blood. Activation of the infection can last from 2-3 weeks to several months, it all depends on the strength of the immune system.

When immunodeficiency prognosis is unfavorable, as well as premature. In other cases, cytomegalovirus infection occurs favorably and mostly without symptoms.

Types of cytomegalovirus infection

Depending on the clinical manifestations, CMV infection may be:

  • asymptomatic carriage
  • congenital infection
  • acquired infection in the neonatal period,
  • mononucleosis-like infection,
  • cytomegaly in immunodeficiencies,
  • cold-like syndrome.

Causes and mechanisms of development

CMV infection results from infection with cytomegalovirus, which got its name because of its ability to form gigantic cells in the body.

Cytomegalovirus is common among adults, by the age of 30, half of the adult population has antibodies to CMV infection. Most of them are asymptomatic carriage or malady symptoms of the disease. Activation of cytomegalovirus and the manifestation of infection occurs in special periods of life, characterized by physiological or pathological decline in immunity.

It is possible:

  • during pregnancy
  • in the neonatal period, especially in premature babies,
  • in case of immunodeficiency of congenital and acquired nature,
  • in chronic infections affecting the lymphatic and immune system,
  • with cancer,
  • after organ or bone marrow transplantation.

Cytomegalovirus is not a highly contagious infection, its transmission requires numerous and prolonged contacts. Usually infected

  • sexually (for any kind of sexual contact),
  • airborne (sneezing and coughing),
  • domestic (when kissing, licking the spoons and nipples of children),
  • transplacental route (from mother to fetus),
  • with blood transfusions (with blood transfusions).  

The ingress of cytomegalovirus in the blood causes activation of the immune system and the formation of antibodies and specific lymphocytic cells, which allows long-term suppression of the virus. However, when immunosuppression is suppressed, cytomegalovirus infection gives symptoms.

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