Cytomegalovirus (CMV) is a common viral illness. It belongs to the herpes virus family.

CMV remains dormant in the body for life. Reactivation of the virus can occur but this is not common and does not usually result in illness. carried by people; not associated with food, water or animals. Pathophysiology The pathologic hallmark of CMV infection is an enlarged cell with viral inclusion bodies. owl's eye - microscopic description infects the epithelial cells of the salivary gland, resulting in a persistent infection infection of the genitourinary system Transmission not considered to be highly contagious respiratory droplets- most common urine, tears, saliva, blood, semen, cervical secretions and breast milk. Sexual contact, intravenous drug use, blood transfusions and organ transplantation. CMV can also cross the placenta. Children in day care or preschool are a significant risk group. Clinical Manifestations fatigue, fever, sore throat, headache, and swollen glands. Fevers often resolve in 10 days, but if the spleen and lymph nodes become swollen, these swellings can take about a month to go away. Fatigue may persist for an additional few months. Common symptoms of cytomegalovirus Cough Enlarged liver and glands, such as the spleen and lymph nodes Fatigue Fever General ill feeling Headache Loss of appetite Muscle aches and pains Nausea with or without vomiting Rash Sore throat Serious symptoms that might indicate a life-threatening condition Change in level of consciousness or alertness, such as passing out or unresponsiveness Change in mental status or sudden behavior change, such as confusion, delirium, lethargy, hallucinations and delusions Chest pain or pressure

High fever (higher than 101 degrees Fahrenheit) Seizure Yellowing of the skin and whites of the eyes (jaundice)

Reducing your risk of cytomegalovirus lower your risk of cytomegalovirus by: Avoiding contact with the saliva or urine of children Cleaning surfaces that might have come in contact with the saliva or urine of children Washing your hands frequently with soap and water DIAGNOSTIC TESTS Virus Isolation Cell culture DEAFF ( Detection of early antigen fluorescent foci) Histopathology PCR CMV antigenaemia test Tissue immunofluorescence Electron microscopy ELISAs for CMV antigen in the urine REMEMBER! Urine should be collected a sterile container without additives. Saliva samples should first be soaked on to a swab which is then broken off into transport medium. Blood should be collected into a heparinized bottle. Tissue biopsies should be placed in sterile plastic containers. Cell Culture Human embryo lung fibroblasts are most commonly used. The specimen is inoculated into HEL cells and kept for 28 days. CMV produces a typical focal cytopathic effect. DEAFF This is a method used for the early diagnosis of CMV infection. The specimen is inoculated into cell culture which is examined 16-24 hours later by immunofluorescence for expressed CMV encoded early proteins.. HISTOPATHOLOGY Cytomegalic inclusions can be recognized from biopsy material by the typical "owl 's eyes appearance " CMV antigenaemia test this test is based upon the detection of pp65, a structural protein expressed on the surface of infected polymorphonyclear leucocytes.

The number of infected leucocytes present had been reported to correlate with the severity of infection.

DIAGNOSTIC TEST Serology CMV IgM antibodies are detected in primary infection and lasts 3 - 4 months. not detectable in recurrent infection except in immunocompromised patients. Rising titres of IgG can be used as markers of acute infection. particularly useful in diagnosing recurrent infections in normal individuals, and in immunocompromised patients who may not develop a IgM response to primary infection. COMPLICATIONS CMV mononucleosis (a sore throat, swollen glands and tonsils, fatigue, nausea) GI complications (diarrhea, abdominal pain, gastritis, ulcerative lesions) Encephalitis Cytomegalovirus pneumonia CMV hepatitis CONGENITAL CMV COMPLICATIONS: Hearing loss Eye abnormalities central vision loss Rretinitis Uveitis) Mental disability Attention-deficit/hyperactivity disorder Autism Death CYTOMEGALOVIRUS INFECTIONS TREATMENT Usually doesn't require treatment, typically resolve on their own without treatment Antiviral drugs are usually prescribed, which slows the virus down If you are pregnant and your baby has CMV, Doctor will likely check your baby once he or she is born for any problems or birth defects so they can be treated early. Treatable symptoms in newborns include pneumonia, hearing loss and inflammation of the eye.

(but cannot cure CMV; medications if you have a weakened immune system.). but it can take weeks or months for the symptoms to go away completely. Fevers often resolve in 10 days, but if the spleen and lymph nodes become swollen, these swellings can take about a month to go away. Fatigue may persist for an additional few months. If your immune system is weakened, your doctor may use one of several different medicines to treat CMV infection. However, because CMV is a virus, regular antibiotics won't work against it. Antiviral medications used to treat cytomegalovirus include: Cidofovir (Vistide) Foscarnet (Foscavir) Ganciclovir (Cytovene) Valganciclovir (Valcyte) anti-viral agents can reduce hearing loss, CMVrelated hepatitis and CMV-related gastroenteritis in newborns. Vaccines are still in the research and development stage and are years away from widespread use.