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Questions and Answers
What is the characteristic rash of congenital cytomegalovirus infection?
What is the primary site of replication for cytomegalovirus?
What is the term for the condition where the fetus experiences heart failure leading to severe edema?
What is the primary cell type that cytomegalovirus infects in a latent state?
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What is the percentage of asymptomatic cases of congenital cytomegalovirus infection?
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What is the term for the condition where the virus can be inactivated when immunosuppressed individuals are treated?
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What is the most common fetal viral infection?
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What is the primary neurological complication of congenital cytomegalovirus infection?
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What is the most common cause of intrauterine infections and congenital abnormalities?
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What is the characteristic feature of CMV esophagitis and colitis?
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What is the significance of IgM antibodies in CMV infection?
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What is the typical appearance of CMV retinitis?
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What is the treatment for CMV infection in patients with a UL97 gene mutation?
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What is the characteristic feature of CMV inclusion bodies?
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How is CMV transmitted?
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What is the significance of CD4 count less than 50 in CMV infection?
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What is the differential diagnosis of CMV mononucleosis?
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Study Notes
Cytomegalovirus (CMV)
- CMV is a DNA virus that replicates in the nucleus and is a member of the herpes virus family.
Characteristics
- CMV can remain latent in mononuclear cells (leukocytes) and can be reactivated when immunosuppressed.
- The virus can be transmitted through contact with infected body fluids, sexually, parenterally, and in utero.
Congenital Infections
- CMV is the most common fetal viral infection and presents with a blueberry muffin rash (thrombocytopenia) and petechial rash, similar to congenital rubella.
- Congenital CMV infections can cause hepatomegaly and jaundice, as well as sensorineural hearing loss and ventriculomegaly with calcifications around the ventricles.
Effects of Congenital Infections
- Congenital CMV infections can lead to mental retardation and seizures due to intracranial calcifications.
- Most cases (80-90%) are asymptomatic, but the highest risk of congenital CMV is in the second trimester.
Complications
- CMV can cause hydrops fetalis, leading to heart failure and severe edema.
- It is the #1 cause of mental retardation and sensorineural hearing loss due to viral infection.
Immunocompromised Individuals
- CMV pneumonia is a risk for organ transplant patients and those with HIV/AIDS who have low CD4 counts (<50).
- CMV retinitis can occur in immunocompromised individuals and presents like a pizza pie.
Treatment and Diagnosis
- CMV can be diagnosed using a buffy coat culture with anti-CMV antibodies.
- Treatment options include ganciclovir and foscarnet (for UL97 gene mutations).
- CMV esophagitis and colitis can be differentiated from herpes by the presence of singular, deep, and linear ulcerations.
Other
- Owls eye inclusion bodies are a characteristic of CMV infection.
- CMV mononucleosis can occur, which is similar to regular mononucleosis but with a negative Monospot test.
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