What Is Cytomegalovirus? Causes, Symptoms and Treatment

December 28, 2019
Cytomegalovirus infections, related to chickenpox and infectious mononucleosis, are very common worldwide. In the following article, we'll learn all about them.

Cytomegalovirus (CMV) is a type of virus that is found worldwide and is directly related to the virus that causes chickenpox and infectious mononucleosis. This pathology can be spread through body fluids and, in most cases, people don’t even know that they’re infected. In pregnant women, it’s possible to transmit the virus to the baby, hence its danger.

Causes of cytomegalovirus

Cytomegalovirus infections spread through bodily fluids such as blood, saliva, urine, semen, and breast milk. There is currently no cure; however, treatments can be useful to help treat newborns and people with weak immune systems.

What Is Cytomegalovirus?

As for babies, in most cases, they appear to be healthy at birth, but they begin to show symptoms over time. They may even arise after months or years. This is directly related to specific pathologies that occur, in some cases, due to the existence of the virus.

Postnatal cytomegalovirus infection can also occur by having contact with the maternal genital tract during childbirth.

Symptoms of cytomegalovirus

An acquired cytomegalovirus infection generally has an asymptomatic course. This is because most of these infections result from a reactivation of the virus in the mother, so the baby is born with protective antibodies. Babies infected with cytomegalovirus can have the following pathologies:

Pneumonitis

This term refers to inflammation of the lung tissue, so pneumonia is considered a type of pneumonitis because the infection causes inflammation. However, doctors often refer to pneumonitis as the non-infectious causes of pulmonary inflammation.

Hepatitis

Hepatitis is an inflammation of the liver. This condition may appear suddenly or evolve into fibrosis. In the case of hepatitis A and B, they can usually be caused by ingestion of contaminated food or water. On the other hand, hepatitis B, C, and D are produced by having contact with infected bodily fluids.

Enteritis

Enteritis is an acute or chronic inflammation that occurs in the small intestine. Generally, the most common cause is of infectious origin (bacterial, viral, or parasitic). But it can also be of ischemic origin, by radiation (radiation enteritis).

What Is Cytomegalovirus?

Lymphadenopathy

This is usually the least frequent pathology that can occur to determine the cytomegalovirus infection. Lymphadenopathy describes swollen lymph nodes.

Diagnosis cytomegalovirus

The detection of cytomegalovirus DNA by PCR amplification has shown to be sensitive enough for identifying cytomegalovirus in a variety of biological samples such as urine, saliva, serum, blood, cerebrospinal fluid (CSF), biopsy material, feces, or bronchoalveolar lavage.

The detection of cytomegalovirus in urine in the first two weeks after giving birth allows doctors to diagnose the congenital infection. This is the minimum amount of time required for the virus to be detected after transmission during delivery.

To diagnose an acquired infection with certainty, we must have a negative urine culture or PCR sample in the first two weeks of life and a subsequent affirmative determination.

Treatment

As a treatment, the doctor will indicate effective antiviral drugs. Doctors typically recommend intravenous ganciclovir in doses of 12 mg/kg a day in two doses for at least two weeks.

As suggested by two specialists, A. Alarcón Allen and F. Baquero-Artigao, of the Spanish Association of Pediatrics, the treatment should be contraindicated or suspended if the number of neutrophils is less than 500/mm3, at least temporarily until a spontaneous recovery or by a treatment with granulocyte colony-stimulating factor.

Recommendations

The Spanish Association of Pediatrics recommends some preventive guidelines in their publication: “Review and Recommendations on the Prevention, Diagnosis, and Treatment of Postnatal Cytomegalovirus Infection.”

  • Freezing breast milk reduces the risk of transmission.
  • Don’t pasteurize breast milk to eliminate the cytomegalovirus.
  • Proper hand hygiene reduces the risk of horizontal transmission of cytomegalovirus.
  • The duration of treatment should be two weeks, evaluating the clinical response.
  • It’s preferable for newborns to have a saliva or urine test taken as well.

It’s essential that when confirming that the baby is suffering from this viral infection, the parents follow all the recommendations and treatments indicated by the attending physician.

  • A. Alarcón Allen y F. Baquero-Artigao. (2010). Revisión y recomendaciones sobre la prevención, diagnóstico y tratamiento de la infección posnatal por citomegalovirus. Grupo de estudio de la infección por citomegalovirus de la Sociedad Española de Infectología Pediátrica. https://doi.org/10.1016/j.anpedi.2010.05.024