infectious diseases
Cytomegalovirus (CMV) Infection
Introduction
Cytomegalovirus (CMV, human herpesvirus type 5) can cause infections that have a wide range of severity. A syndrome of infectious mononucleosis that lacks severe pharyngitis is common. Severe focal disease, including retinitis, can develop in HIV-infected patients and in organ transplant recipients and other patients who are immunocompromised. Severe systemic disease can develop in neonates and patients who are immunocompromised. Laboratory diagnosis, helpful for severe disease, may involve culture, serologic testing, biopsy, or antigen or nucleic acid detection.Ganciclovirand other antiviral medications are used to treat severe disease, particularly retinitis. (See also Overview of Herpesvirus Infections and CMV (human herpesvirus type 5) is transmitted through blood, body fluids, or transplanted organs. Infection may be acquired transplacentally or during birth. Prevalence increases with age; 50 to 90% of adults have CMV infection (resulting in lifelong latent infection) ( General references ). Lower socioeconomic groups tend to have a higher prevalence. Congenital and Perinatal Cytomegalovirus Infection (CMV) may be asymptomatic or may cause abortion, stillbirth, or postnatal death. Complications include extensive hepatic and central nervous system (CNS) damage. Acquired infections are often asymptomatic. An acute febrile illness, termed CMV mononucleosis, may cause hepatitis with elevated aminotransferases (usually subclinical without jaundice), and atypical lymphocytosis similar to Infectious Mononucleosis due to Epstein-Barr virus (EBV). Postperfusion/posttransfusion syndrome can develop 2 to 4 weeks after transfusion with blood products containing CMV. It causes fever lasting 2 to 3 weeks and the same manifestations as CMV mononucleosis. CMV is a major cause of morbidity and mortality. Disease often results from reactivation of latent virus. The lungs, gastrointestinal tract, or CNS may be involved. In the terminal phase of AIDS, CMV infection causes Herpesviruses: Cytomegalovirus about 30% of patients and causes funduscopically visible retinal abnormalities ( 