Cytomegalovirus - causes, symptoms, diagnosis and treatment
Cytomegalovirus - Infectious disease of viral origin, sexually transmitted, transplacental, household, by blood transfusion. Symptomatic proceeds in the form of persistent cold. Marked weakness, malaise, headaches and joint pain, runny nose, and an increase in inflammation of the salivary glands, excessive salivation. Often asymptomatic. The severity of the disease is due to the general state of immunity. In generalized form of severe pockets of inflammation occur in the body. Salivary gland disease is dangerous during pregnancy: It can cause spontaneous miscarriage, congenital malformations, fetal death, congenital cytomegaly.
Cytomegalovirus
Human herpesvirus. Cells infected with cytomegalovirus, increased many times in size, so the name of the disease "salivary gland disease" is translated as "giant cells".
Cytomegalovirus is a common infection, and many people, being carriers of cytomegalovirus, are not even aware of it. The presence of antibodies to CMV is diagnosed in 10-15% of the population in their teens and 50% of adults. According to some sources, the carrier is determined by the cytomegalovirus, 80% of women of child-bearing period. This primarily refers to the asymptomatic and malosimptomno downstream of cytomegalovirus infection.
Not all people-carriers of cytomegalovirus are sick. Often cytomegalovirus is in the body for many years and may never prove themselves and not cause harm to humans. The manifestation of latent infection occurs usually when loosening immunity. Threatens in its consequences is the risk of cytomegalovirus in patients with reduced immunity (HIV infection undergoing bone marrow transplantation or internal organs, taking immunosuppressants) for congenital cytomegalovirus form, in pregnant women.
Congenital salivary gland disease may manifest in newborns in various forms:
Mortality in utero infection with cytomegalovirus reaches 20-30%. Of the survivors, most have mental retardation or hearing disability and vision.
Acquired salivary gland disease in newborns
When infected with CMV during delivery (when the fetus through the birth canal) or in the postpartum period (for casual contact with an infected mother or breastfeeding) in most cases develops asymptomatic CMV infection. However, in preterm infants cytomegalovirus can cause protracted pneumonia, which is often joined by concomitant bacterial infection. Often when defeat cytomegalovirus in children marked slowdown in physical development, lymph node enlargement, hepatitis, rash.
mononucleosis syndrome.
Individuals that have emerged from the neonatal period and with a normal immune system, CMV can cause mononucleosis syndrome develop. Current mononukleazopodobnogo syndrome at the clinic is not different from infectious mononucleosis caused by another kind of herpes virus - the virus Ebstein-Barr virus. Current mononucleosis syndrome resembles coed persistent infection. It is noted:
In some cases, mononucleosis syndrome accompanied by the development of hepatitis - jaundice and increased liver enzymes in the blood. Even fewer (6% of cases) is a complication of mononucleosis syndrome pneumonia. However, in persons with normal immune reactivity, it occurs without clinical manifestations, revealed only during the X-ray light.
Duration of course mononucleosis syndrome is 9 to 60 days. Then usually comes a full recovery, although for several months may be stored residual symptoms of malaise, weakness, swollen lymph nodes. In rare cases, the activation of cytomegalovirus infection causes recurrent fever, sweating, hot flashes, and malaise.
Cytomegalovirus infection in people with weakened immune systems
The weakening of the immune system is observed in patients suffering from the syndrome of congenital and acquired (AIDS), immunodeficiency, as well as in patients undergoing transplantation of internal organs and tissues: heart, lung, kidney, liver, bone marrow. After organ transplantation, patients taking immunosuppressants permanently forced, leading to a marked suppression of immune responses that cause cytomegalovirus activity in the body.
In patients who have undergone organ transplants, cytomegalovirus causes damage to donor tissue and organs (hepatitis - liver transplant, pneumonia with lung transplant, etc). After bone marrow transplantation in 15-20% of patients can lead to cytomegalovirus pneumonia with high mortality (84-88%). The most dangerous is the situation when an infected donor material cytomegalovirus uninfected transplanted to the recipient.
Cytomegalovirus affects virtually all HIV-infected people. At the beginning of the disease marked malaise, joint and muscle pain, fever, night sweats. In the future, these signs can be attached defeat cytomegalovirus lungs (pneumonia), the liver (hepatitis), the brain (encephalitis), retinal (Rita), ulcerative lesions and gastrointestinal bleeding.
Men cytomegalovirus may be affected testes, prostate, women - the cervix, the inner layer of the uterus, vagina, ovaries. Complications of CMV infection in HIV-infected individuals may be internal bleeding from the affected organs, loss of vision. Multiple organ failure CMV can lead to dysfunction and the patient's death.
Diagnostic PCR (polymerase chain reaction). Especially informative conduct quantitative PCR, which gives an idea of the activity of cytomegalovirus and it causes infection. Diagnosis of cytomegalovirus infection is based on the allocation of CMV in clinical material or a four-fold increase in antibody titer.
Depending on which organs are affected cytomegalovirus infection, the patient needs to consult a gynecologist, an andrologist, a gastroenterologist or other specialist. Additionally, on the testimony of the ultrasound scan of the abdominal cavity, colposcopy, gastroscopy, brain MRI, and other tests.
thrombocytopenia, skin reactions, gastrointestinal disorder, fever and chills, and others.), its use is limited in pregnant women, children and people suffering from renal failure (only for health reasons), it is not used in patients without impaired immunity.
For the treatment of CMV in HIV-infected most effective drug foscarnet, also has a number of side effects. Foscarnet may cause a violation of electrolyte metabolism (decrease in blood plasma magnesium and potassium), ulceration of the genital organs, violation of urination, nausea, kidney damage. These side reactions require careful application and timely adjustments in dose.
pregnancy, as it can provoke miscarriage, stillbirth or cause severe birth defects in the child. Therefore, cytomegalovirus, along with herpes, toxoplasmosis and rubella, is one of those infections, which surveyed women should prophylactically, even at the stage of planning of pregnancy.