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CYTOMEGALOVIRUS (CMV)

 Cytomegalo Virus  True Viral Latency


- Most common worldwide from  Presence of genetic
MOTHER  CHILD information in an
- Targets the WBC unexpressed state in
 Transmission: the host cell
 Oral  Congenital Infection
 Respiratory  Infected Infants:
 Venereal  Premature infants
 Blood Transfusion  DEATH
 Tissue Transplant  Newborns
 May be Isolated:  With mental
 Urine, Saliva impairment &
 Breastmilk health
 Feces complications
 Blood  Classic Congenital CMV
 Serum Syndrome
 Vaginal fluid  Neurologic symptoms,
 Respiratory droplets neuromuscular
 Irradiated Blood disorders
 Jaundice ,
 High Risks Groups hepatomegaly,
 Health-Care Professionals splenomegaly
 Immunosuppressed individuals  Cytomegalic Inclusion Disease
- Preventive measures of transfusion (CID)
related CMV infection  Permanent neurologic
 Proper hygiene, PPEs complications
 Effective blood donor  Mental retardation
screening  Vision defects
 Transfusion of LD  Deafness
(leukocyte deficient) blood  Microencephaly
products  Motor dysfunction
 Immune globulin  Intracranial
 Latent Infection calcifications *
 Active CMV infection can (↑ white mater)
develop through:  Acquired CMV
 Pregnancy  Mononucleosis
 Immunosuppression  CMV hepatitis
 Exposure to virus: BT,
BMT, SCT, Allograft
transplant
SYMPTOMS: CHARACTERISTIC Ab RESPONSE

 Sore throat  Primary Infection


 Swollen glands  Transient virus – specific
 Chills IgM response
 Malaise & myalgia  Reactivation
 Lymphadenopathy  ↑ in IgG ; no detectable IgM
 Splenomegaly response
 Reinfection
↓ CD4 ↑CD8
 IgG response; not
3 TYPES OF CMV INFECTIONS IN BT confirmed if there is IgM
RECIPIENTS reponse

 PRIMARY INFECTION Laboratory Evaluation


 Seronegative patient and and
 Immunocompromisedindividuals:
actively or latently infected
 Viral culture
donor
 PCR
 Spx of choice: urine and blood
 Immediately Ab response
occurs
 REACTIVATED INFECTION
 Seropositive patients & CMV-
Ab (+) or (-) donor
 REINFECTION
 A different CMV srain in the
donor’s blood triggers activation
of infection
SEROLOGIC MARKERS
 Present in nuclei of infected
cells:
 Immediate-Early
Antigens: 1hour
 Early Antigens:
24hours
 Late Antigens:
72hours; present in
cytoplasm & nucleus
 Immune Ab Response:
 Active Infection:
Immediate-Early &
early Ag
 Viral Shedding: Early
Ag
 Recovery: Late Ag