Infectious diseases

Cytomegalovirus infection

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Cytomegalovirus infection
portrait of Clara Boter Carbonell Ph.D.
Written by

Clara Boter Carbonell Ph.D.
Medically reviewed by our Medical staff

Last update: 12-07-2022

How else can it be called?

  • CMV

  • CMV mononucleosis

  • CIE-10: B25

What is cytomegalovirus infection?

Cytomegalovirus (CMV) is a virus related to the group of herpes viruses, that may cause flu-like symptoms in healthy people and symptoms similar to mononucleosis in people with a weakened immune system.

Cytomegalovirus infection is very common worldwide (it is believed that more than 50% of adult population have been infected at some point in their lives). It does not cause disease in people with a competent immune system or just a simple cold.

However, it may cause serious problems in people with a weakened immune system or in babies infected with CMV before birth (congenital cytomegalovirus).

CMV remains inactive (dormant) within the body for life after the initial infection. It usually reactivates when the immune system is stressed.

What causes cytomegalovirus infection?

Cytomegalovirus is passed between people through contact with body fluids. It can be spread through:

  • Saliva
  • Tears
  • Semen
  • Vaginal fluids
  • Urine
  • Breast milk
  • Respiratory droplets
  • Blood transfusion
  • Organ transplantation
  • Through the placenta in pregnancy

Which are the main symptoms of cytomegalovirus infection?

In a healthy person, initial CMV infection often occurs without any symptoms or just like a simple cold. Occasionally, a first-time infection with CMV may cause a mild illness called mononucleosis.

The most common symptoms are:

  • Fever
  • Sore throat
  • Fatigue
  • Swollen glands and tonsils
  • Muscle aches and pain (myalgia)

In people with a weakened immune system, CMV infection can cause more serious and potentially life-threatening illnesses. These illnesses include:

  • Inflammation of the liver (hepatitis) and the spleen (splenomegaly)
  • Inflammation of the brain (encephalitis)
  • Diarrhea
  • Gastric ulcers that cause blood in the stool
  • Inflammation in the lungs (pneumonitis)
  • Seizures
  • Coma

Babies infected before birth or during delivery may develop diseases later in childhood. About 20% of these babies will later develop severe hearing impairments. Some babies (the most affected ones) may develop soon after birth symptoms such as:

  • Jaundice (a yellow color of the skin or eyes)
  • Low birth weight
  • Enlarged spleen (splenomegaly)
  • Enlarged liver (hepatomegaly)
  • Chorioretinitis (inflammation of the choroid and the retina of the eye)
  • Pneumonia
  • Seizures

How can it be diagnosed?

In order to get a proper diagnosis, the following test can be performed:

  • Blood test with platelet and WBC (White Blood Cell) count
  • Biochemical analysis
  • Heterophile antibody test

Which is the recommended treatment?

Healthy people who are infected with CMV usually do not require medical treatment. Most patients usually recover within 4 to 6 weeks. Analgesics can be used for the related symptoms.

In patients with a weakened immune system, it is usually prescribed antiviral drugs (Ganciclovir, Valganciclovir, Valaciclovir). Foscarnet or Cidofovir may also be prescribed for resistant cases but they must be administered with caution because these drugs have significant side effects.

Medically reviewed by our Medical staff on 12-07-2022

Bibliography

  • CDC (2016) About CMV. Available on: https://www.cdc.gov
  • Isselbacher, K.J., Harrison, T.R., Fauci, A.S., Longo, D.L., Hauser, S.L. and Jameson, L.J. (2004) Harrisons principles of internal medicine - 2 volume set. Edited by Dennis Kasper and Eugene Braunwald. 16th edn. New York: McGraw Hill Higher Education.
  • Kenna, M.A. (2015) ‘Acquired hearing loss in children’, Otolaryngologic Clinics of North America, 48(6), pp. 933–953. doi: 10.1016/j.otc.2015.07.011.
  • Crumpacker CS II, Zhang JL. Cytomegalovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009:chap 138.
  • Principles and Practice of Clinical Virology (5th Ed) 2004, Paul D. Griffiths, ISBN: 0-470-84338-1, Pag. 85.
  • Diagnostic Pathology of Infectious Disease. 2nd edition. Richard L. Kradin. 2018. ISBN: 978-0-323-44585-6. Pág. 282.

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