Infectious diseases. Cytomegalovirus infection (most important)

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Infectious diseases. Cytomegalovirus infection (most important)

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45. Cytomegalovirus infection

Cytomegalovirus infection often goes unnoticed, but infection before, during, or shortly after birth usually causes severe illness.

Etiology. Cytomegalovirus is a species-specific agent, similar in its physicochemical and electron microscopic properties to the herpes virus.

Epidemiology. The source of infection is only a person, a sick person or a virus carrier.

Transmission is carried out, apparently, mainly by contact, less often by airborne and enteral routes, as well as parenterally, newborns can become infected through mother's milk; transplacentally.

Pathology. Under light microscopy in tissues with a high titer of the virus, large intranuclear inclusions are determined. Their large size in the cells of the liver, kidneys, lungs, in the urine sediment allows you to make an accurate diagnosis.

Clinical manifestations. The incubation period seems to range from 15 days to 3 months.

congenital infection. Commonly observed symptoms, in decreasing order of frequency, are hepatosplenomegaly, jaundice, purpura, microcephaly, brain calcification, and chorioretinitis. Any of the manifestations can occur in isolation.

For many children, the only symptoms are developmental delays and irritability.

The most common and important sign of congenital infection is a violation of the function of the central nervous system.

Acquired infection, as well as congenital, is most often asymptomatic.

It is not uncommon for babies to become infected from their mother during the 2nd stage of labor, and the virus begins to be shed in their urine after a few weeks.

In older children and adults, mononucleosis due to cytomegalovirus is the main manifestation of the disease.

The feeling of weakness and fatigue persists for a long time. Chills and daily fever of 40°C or more may last for 2 weeks or more. An early and important sign is atypical lymphocytosis.

Diagnostics. Based on clinical data alone, it is impossible to make a diagnosis of cytomegalovirus infection. Laboratory diagnostics is based on:

1) cytological studies;

2) virological studies;

3) serological studies.

With generalized cytomegaly, the use of corticosteroid hormones, intramuscular use of interferon or reaferon, the introduction of vitamins C, K, P, group B are indicated, antibiotics are prescribed when a bacterial infection is layered and complications occur. Due to the immunosuppressive effect of the virus, immunostimulants are prescribed.

Prevention. It is advisable to examine all pregnant women for cytomegaly, as well as women who have had ARVI during pregnancy, newborns with jaundice.

Author: Pavlova N.V.

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