University:
Eastern Kentucky University
Course:
BIO 273 | Clinical Microbiology
Academic year:

2022
Views:

364

Pages:

3
Author:

Shyanne Johnson

Cytomegalovirus Features: 1. Herpes virus family 2. It remains latent in mononuclear cells such as: a. Lymphocytes b. Macrophages c. Monocytes 3. Reactivation occurs by immucompromisation 4. It is a TORCHeS infection Transmission: 1. 2. 3. 4. 5. Sex Blood Saliva Urine Vertical Transmission Diseases: The diseases of CMV can be divided in following points: 1. 2. 3. 4. Congenital CMV Fetal CMV Immunocompetent CMV Immunocompromised CMV: a. Transplant patients b. AIDS patients Congenital CMV: It is asymptomatic in 80-90% of cases. In the other 10-20% cases it causes following symptoms: 1. Blueberry Muffin Rash a. Petechial rash (due to thrombocytopenia) 2. Hepatospleenomegaly 3. Jaundice 4. Sensorineural deafness 5. Intracranial calcifications: a. Around ventricles (periventricle calcification) b. Around parenchyma c. Leads to seizures 6. Ventriculomegaly 2nd trimester is associated with highest risk of CMV. CMV is #1 cause of mental retardation due to congenital viral infection and also the #1 cause of sensorineural deafness. Fetal CMV: Fetal CMV can cause Hydrops Fetalis which is characterized by: 1. Edema a. Due to heart failure 2. Spontaneous abortion Immunocompetent CMV: CMV in adults can lead to CMV Mononucleosis which is characterized by following: 1. It occurs in immunocompetent patients 2. It has same features as EBV mononucleosis a. The differentiation point is that in contrast to EBV mononucleosis, CMV mononucleosis gives negative monospot test Immunocompromised CMV: Two types of patients are at risk of CMV: 1. Transplant patients a. CMV can cause CMV Pneumonia b. Buffy Coat Culture is performed to detect CMV in transplant patients 2. AIDS patients a. CMV infection occurs only if CD4+ count is <50 b. CMV infection can cause following: i. CMV Retinitis ii. CMV Esophagitis iii. CMV Colitis The details of these three diseases are given below: 1. CMV Retinitis (pizza pie retinopathy) can cause: a. Blind spots b. Flashing lights c. Vision loss d. It is typically unilateral but the other eye can be involved too if the infection is not treated 2. CMV esophagitis In contrast to CMV a. Singular, deep and linear ulcerations esophagitis, Herpes 3. CMV Colitis esophagitis has multiple and a. Ulcerated walls shallow ulcerations Lab Diagnosis: Owl’s eye inclusion bodies are seen Treatment: 1. Gancyclovir 2. Foscarnet a. Used when virus has UL97 mutation i. This mutation makes it resistant to gancyclovir