07-14-2007, 09:49 AM
CMV ( so named becoz infected cells become swollen)
CMV like other herpes family show latency
CMV also invades the WBC like EBV so for lab purpose ther is higher yield if buffy coat is cultures ie layer of WBC in centrifuged blood
Microscopically, CMV can be demonstrated by intranuclear inclusion bodies, which show that the virus replicates in the nucleus rather than the cytosol. These inclusion bodies stain dark pink on an H&E stain, and are also called "Owl's Eye" inclusion bodies.
Presentation
1. Asymptomatic
2. Some persons with symptoms experience an infectious mononucleosis-like syndrome [2], with prolonged fever, and a mild hepatitis. A very sore throat is also common.But heterophile antibodies are negative ti distinguish from EBV
It will become latent then
TRANSMISIION Infectious CMV may be shed in the bodily fluids of any previously infected person, and thus may be found in urine, saliva, blood, tears, semen, and breast milk. The shedding of virus may take place intermittently, without any detectable signs, and without causing symptoms.
CMV can be sexually transmitted and can also be transmitted via breast milk, transplanted organs, and rarely from blood transfusions.
Infection is important to certain high-risk groups.[3] Major areas of risk of infection include pre-natal or post-partum infants and immunocompromised individuals, such as organ transplant recipients, persons with leukemia, or those infected with human immunodeficiency virus (HIV). CMV is considered an AIDS-defining infection, indicating that the T-cell count has dropped to low levels.
CONGENITAL CMV
TORCHES
MCC of viral mental retardation.
To summarize, during a pregnancy when a woman who has never had CMV infection becomes infected with CMV, there is a potential risk that after birth the infant may have CMV-related complications, the most common of which are associated with hearing loss, visual impairment, or diminished mental and motor capabilities. On the other hand, infants and children who acquire CMV after birth have few, if any, symptoms or complications.
When infected with CMV, most women have no symptoms and very few have a disease resembling mononucleosis. It is their developing fetuses that may be at risk for congenital CMV disease. CMV remains the most important cause of congenital viral infection in the United States.
CMV is the most common cause of congenital infection in humans and intrauterine primary infections are second only to Down's syndrome as a known cause of mental retardation.[5]
For infants who are infected by their mothers before birth, two potential problems exist:
ยข Generalized infection may occur in the infant, and symptoms may range from moderate enlargement of the liver and spleen (Hepatosplenomegaly) (with jaundice) to fatal illness. With supportive treatment most infants with CMV disease usually survive.
OR CLASSICAL PRESENTATION
Cutaneous hemorrhages (blueberry muffin body) + sensorineural deafness+ periventricular calcification + mental retardation + microchephaly etc.
IN AIDS PATIENT
CD4 count 50-100 cells per cc CMV RETINITS + COLITIS
IN BONE MARROW TRANSPLANT PATIENS
PNEUMONITIS + COLITIS
CMV like other herpes family show latency
CMV also invades the WBC like EBV so for lab purpose ther is higher yield if buffy coat is cultures ie layer of WBC in centrifuged blood
Microscopically, CMV can be demonstrated by intranuclear inclusion bodies, which show that the virus replicates in the nucleus rather than the cytosol. These inclusion bodies stain dark pink on an H&E stain, and are also called "Owl's Eye" inclusion bodies.
Presentation
1. Asymptomatic
2. Some persons with symptoms experience an infectious mononucleosis-like syndrome [2], with prolonged fever, and a mild hepatitis. A very sore throat is also common.But heterophile antibodies are negative ti distinguish from EBV
It will become latent then
TRANSMISIION Infectious CMV may be shed in the bodily fluids of any previously infected person, and thus may be found in urine, saliva, blood, tears, semen, and breast milk. The shedding of virus may take place intermittently, without any detectable signs, and without causing symptoms.
CMV can be sexually transmitted and can also be transmitted via breast milk, transplanted organs, and rarely from blood transfusions.
Infection is important to certain high-risk groups.[3] Major areas of risk of infection include pre-natal or post-partum infants and immunocompromised individuals, such as organ transplant recipients, persons with leukemia, or those infected with human immunodeficiency virus (HIV). CMV is considered an AIDS-defining infection, indicating that the T-cell count has dropped to low levels.
CONGENITAL CMV
TORCHES
MCC of viral mental retardation.
To summarize, during a pregnancy when a woman who has never had CMV infection becomes infected with CMV, there is a potential risk that after birth the infant may have CMV-related complications, the most common of which are associated with hearing loss, visual impairment, or diminished mental and motor capabilities. On the other hand, infants and children who acquire CMV after birth have few, if any, symptoms or complications.
When infected with CMV, most women have no symptoms and very few have a disease resembling mononucleosis. It is their developing fetuses that may be at risk for congenital CMV disease. CMV remains the most important cause of congenital viral infection in the United States.
CMV is the most common cause of congenital infection in humans and intrauterine primary infections are second only to Down's syndrome as a known cause of mental retardation.[5]
For infants who are infected by their mothers before birth, two potential problems exist:
ยข Generalized infection may occur in the infant, and symptoms may range from moderate enlargement of the liver and spleen (Hepatosplenomegaly) (with jaundice) to fatal illness. With supportive treatment most infants with CMV disease usually survive.
OR CLASSICAL PRESENTATION
Cutaneous hemorrhages (blueberry muffin body) + sensorineural deafness+ periventricular calcification + mental retardation + microchephaly etc.
IN AIDS PATIENT
CD4 count 50-100 cells per cc CMV RETINITS + COLITIS
IN BONE MARROW TRANSPLANT PATIENS
PNEUMONITIS + COLITIS