infectious diseases
Cytomegalovirus (CMV) Infection
Diagnosis of Cytomegalovirus
Detection of CMV antigen or DNA Urine culture in infants Biopsy of tissue that may be infected in patients who are immunocompromised Serologic testing CMV infection is suspected in Healthy people with mononucleosis-like syndromes Patients who are immunocompromised and have gastrointestinal, lung, CNS, or retinal symptoms Neonates with systemic disease CMV mononucleosis can be differentiated from Infectious Mononucleosis by the usual lack of pharyngitis, a negative heterophile antibody test, and positive CMV serologic testing. CMV infection affecting the liver can be differentiated from other viral hepatitis infections by Seroconversion can be demonstrated by development of CMV antibodies and indicates new CMV infection. However, CMV disease can also result from reactivation of latent disease in immunocompromised hosts. Reactivation of CMV can result in virus in the urine, other body fluids, or tissues, but the presence of CMV in body fluids and tissues does not always indicate disease and may merely represent viral shedding. Therefore, biopsy showing CMV-induced abnormalities in infected tissue is often necessary to demonstrate invasive disease. Quantitative detection of CMV antigen or DNA in the peripheral blood can also be very helpful because an elevated or rising CMV viral load is often highly suggestive of invasive disease. Such CMV detection can be particularly helpful in patients who are severely immunocompromised with compatible clinical syndromes in whom biopsy may not be feasible. Diagnosis of CMV infection in infants can be made by urine culture. 