Signs and Symptoms

Objective
Explain the signs and symptoms of acquired and congenital CMV infection

Acquired CMV Infection

GENERAL INFORMATION
· Asymptomatic
· Persist in the host as a chronic or latent infection
· Incubation Period: 3-12 weeks
· Self-limited, heterophile-negative, mononucleosis-like syndrome results (occasional)
· Possible development of CMV hepatitis

SYMPTOMS
· Sore throat and fever
· Swollen glands
· Chills
· Profound malaise
· Myalgia

SIGNS
· Lymphadenopathy
· Splenomegaly

INFREQUENT COMPLICATIONS OF CMV INFECTION

· Interstitial pneumonitis
· Hepatitis
· Guillain-Barré syndrome
· Meningoencephalitis
· Myocarditis
· Thrombocytopenia
· Hemolytic anemia (Spherocytosis)

CMV INFECTION IN IMMUNOSUPRESSED PATIENTS

· Pneumonitis
· Hepatitis
· Gastrointestinal (GI) ulceration
· Arthralgias
· Meningoencephalitis
· Retinitis
· Interstitial pneumonitis (major cause of death after allogeneic bone marrow transplantation)

ACQUIRED CMV INFECTION IN PREMATURE INFANT

· atypical lymphocytosis
· hepatosplenomegaly
· pneumonia
· death

TRANSFUSION-ACQUIRED CMV INFECTIONS

· May cause:
1. mononucleosis-like syndrome
2. hepatitis increased rejection of transplanted organs

THREE TYPES OF CMV INFECTIONS ARE POSSIBLE IN BLOOD TRANSFUSION RECIPIENTS

1. Primary infection

- occurs when a previously unexposed (seronegative) recipient is transfused with

blood from an actively or latently infected donor
- presence of virus in the blood and urine
- immediate antibody response
- eventual seroconversion
- asymptomatic/symptomatic
2. Reactivated infection

- occur when a seropositive recipient is transfused with blood from a CMV

antibody–positive or –negative donor
- significant increases in CMV-specific antibody
- viral shedding (only manifestation)
- largely asymptomatic

3. Reinfection

- occur by a CMV strain in the donor’s blood that differs from the
strain that originally infected the recipient
- Antibody response
- Viral shedding occurs
- Isolates from both donor and recipient is needed to differentiate
reactive infection
Congenital Infection
· 1 in 750 children in the United States develops permanent problems due to cmv
· >5000 children /year suffer permanent problem

CLASSIC CONGENITAL CMV

· Neurologic symptoms
· Neuromuscular disorders
· Jaundice
· Hepatomegaly
· Splenomegaly
· Petechia (most common clinical sign)

Congenitally infected Newborns

cytomegalic inclusion disease (CID)
- Intracranial calcification
- Neurologic sequelae
- Mental retardation
- Deafness
- Vision defect
- Microcephaly
- Motor dysfunction
51% to 75% of survivors
- Psychomotor impairment
21% to 50%
- Hearing loss
20%
- Visual impairment
REFERENCES

Turgeon, ML. Immunology and Serology in Laboratory Medicine 5th edition.

http://www.doctoroz.com

http://www.livestrong.com

http://www.completepaincare.com