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The following text is from an archived Red Book® edition and may not reflect current recommendations or information. To view the current edition, click here.
Section 3. Summaries of Infectious Diseases
Cytomegalovirus Infection
Clinical Manifestations
Etiology
Epidemiology
Diagnostic Tests
Treatment
Isolation of the Hospitalized Patient
Control Measures
CLINICAL MANIFESTATIONS: Manifestations of acquired human cytomegalovirus (CMV) infection vary with the age and immunocompetence of the host. Asymptomatic infections are the most common, particularly in children. An infectious mononucleosis-like syndrome with prolonged fever and mild hepatitis, occurring in the absence of heterophil antibody production, can occur in adolescents and adults. Pneumonia, colitis, and retinitis occur in immunocompromised hosts (particularly people receiving treatment for malignant neoplasms), people infected with human immunodeficiency virus (HIV), and people receiving immunosuppressive therapy for organ transplantation.
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Congenital infection has a spectrum of manifestations but is usually asymptomatic. Some congenitally infected infants who are asymptomatic at birth are later found to have hearing loss or learning disability. Approximately 10% of infants with congenital CMV infection have profound involvement, evident at birth, with manifestations including intrauterine growth retardation, jaundice, purpura, hepatosplenomegaly, microcephaly, intracerebral calcifications, and retinitis.
Infection acquired at birth or shortly thereafter from maternal cervical secretions or human milk usually is not associated with clinical illness. Infection resulting from transfusion from CMV-seropositive donors to preterm infants has been associated with systemic symptoms, including lower respiratory tract disease.
ETIOLOGY: Human CMV, a DNA virus, is a member of the herpesvirus group.
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EPIDEMIOLOGY: Cytomegalovirus is highly species-specific, and only human strains are known to produce human disease. This virus is ubiquitous and is transmitted horizontally (by direct person-to-person contact with virus-containing secretions), vertically (from mother to infant before, during, or after birth), and via transfusions of blood, platelets, and white blood cells from previously infected people (see Blood Safety, p 106). Infections have no seasonal predilection. Cytomegalovirus persists in latent form after a primary infection, and reactivation can
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