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Back to Infectious Diseases
Cytomegalovirus
Cytomegalovirus infection as with other herpes viruses is life-long.
After primary infection it replicates at low levels throughout life. Only
when immunity is suppressed, does the rate of replication increase and reactivation
occurs. Infection is transmitted by blood transfusion, from the mother to
the fetus or by infected organs transplanted from seropositive donors. It
occurs in over 90% of AIDS patients.
Symptoms
In healthy individuals infection is usually asymptomatic but in some
cases it may cause an illness similar to infectious mononucleosis with glandular
fever (fever and lymph gland enlargement) & atypical lymphocytes in the
blood picture.
In immunocompromised patients, it produces widespread visceral involvement
with fever, interstitial pneumonitis (diagnosed by transbronchial biopsy),
hepatitis, hemorrhage, gastroenteritis, choroidoretinitis (inflammation
of the eye).
Intraunterine infection results in microcephaly (small head), motor disorders
(e.g paralysis), jaundice, hepatosplenomegaly (enlargement of the liver
and spleen), thrombocytopenia (low platelet counts) and hemolytic anemia
(anemia as a result of breaking down of red blood cells).
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Diagnosis
Serological diagnosis: IgM antibodies denote current infection while
IgG antibodies denote past infections. The virus can be identified in tissues
by the presence of the characteristic intranuclear (owl's eye) inclusions
and by direct immunofluorescence. It can also be cultured in the human embryo
fibroblasts with immunofluorescent detection of antigens in the culture.
Treatment
In immunocompetent individuals, no specific therapy is indicated and
infection is self limited.
Gancyclovir is the treatment of choice in immunocompromised
individuals.
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