Introduction
-CMV is a double-stranded DNA herpes virus
-It is present in urine, saliva, semen, and cervical secretions.
-It’s transmission occurs through person-to-person,mother-to-fetus/infant, sexual contact, breastfeeding, blood products, transplantation routes
-CMV is the most common viral pathogen complicating organ transplantation
Symptoms & Signs
-Most CMV infections are asymptomatic
-Acute acquired CMV infection is similar to infectious mononucleosis, though exudative pharyngitis or cervical lymphadenopathies are uncommon
-There are three recognizable clinical syndromes:
(1) Perinatal disease: Congenital infection is a leading cause of deafness; It is characterized by microcephaly, periventricular CNS calcifications, mental retardation, motor disability, thrombocytopenia, hepatitis.
(2) diseases in immunocompetent persons : CMV causes mononucleosis-like syndrome with negative heterophile antibodies; It is characterized by fever, malaise, arthralgias, myalgias, splenomegaly; Cutaneous rashes (including the typical maculopapular rash after exposure to ampicillin)
(3) diseases in immunocompromised persons: CMV causes serious illnesses such as CMV retinitis, esophagitis, pneumonitis, encephalitis, transverse myelitis
Diagnosis
Prenatal diagnosis: Amniotic fluid PCR
Postnatal diagnosis:
Serologic testing by PCR
Tissue biopsy: Cytomegalovirus-infected cells showing “owl’s eye” appearance of intranuclear inclusions and intracytoplasmic inclusions
Treatment
Immunocompetent: supportive treatment; no antivirals necessary
Immunosuppressed: Ganciclovir, Valganciclovir,Foscarnet,Cidofovir
HIV patients: CMV is a common cause of serious opportunistic diseases in HIV patients; ART is indicated Prevention: strict personal hygiene