Cytomegalovirus infection

Cytomegalovirus infection

Description of cytomegalovirus infection

Cytomegalovirus belongs to the group of herpes viruses, to which further comprises a herpes virus, chickenpox and herpes zoster, Epstein-Barr virus (EBV, the causative agent of infectious mononucleosis). Viruses of this group have a similar feature – after the initial infection remain present in the body and reflected again in a weakened immunity (ie. The “latent infection”). As Herpes simplex virus remains hidden in nerve cells, cytomegalovirus after initial infection intensively propagated mainly in the salivary glands, kidney and white blood cells, wherein the nucleic acid of the virus and thereby its genetic information (genome) remains throughout adult life.Cytomegalovirus is a worldwide virus that is ubiquitous circulates among the people and it’s population is largely promořena. Seroprevalence world population varies from 50% in developed countries to almost 100% in developing countries where there is high population density and worse health conditions. At first glance it may seem alarming to someone, but the opposite is true. The high infection rate of the population means that people are against this virus developed antibodies and are resistant against him. Antibodies are created after their initial infection (the first encounter with the virus), which occurs in most people without symptoms, so by the individual in question often do not know. Rarely you may develop fever, inflammation of the airways and increased liver enzymes, indicating liver infection. But when it comes to this spread of the virus in the body, activates the immune system and lymphocytes (a type of white blood cell) start to produce antibodies, which then protect the individual against possible future by going through another cytomegalovirus infection and the organism is no longer immune. This is the situation in individuals with healthy immune systems. P an Issue not occur when immunity is impaired for some reason.

Transmission of the virus between people requires close intimate contact with a person who has the virus is excreted in saliva, urine and other body fluids. You can become infected during sexual intercourse, but what is very important, the virus is also transmitted from mother to fetus and throughout pregnancy (passes through the placenta), childbirth, and afterwards, because it can pass into breast milk. Primary cytomegalovirus infection is therefore dangerous especially during pregnancy when the developing fetus infection may cause serious damage. Furthermore, transmission can occur with organ transplants or blood transfusions.

Risk factors of cytomegalovirus infection

A risk factor is any weakening of the immune system. It’s a case of transplantation, the patient is taking medication dampening immunity in the case of AIDS, the immune system is damaged. Risk occurs also in the treatment of cancer. For thus weakened individuals venture intercourse with infected persons can shed virus, so-called carrier, but for example, a blood transfusion.
Risk to the fetus is infected mother during pregnancy, especially primary infection or primary infection.

Symptoms of cytomegalovirus infection

As stated above, infection in healthy people is usually carried out without any apparent clinical signs, because a healthy immune system can easily handle the virus. The situation is different in the case of its weakness. This applies particularly organ transplants and AIDS.

Transplantation (transfer organ donor to a recipient) must be a recipient of organ perform the so-called. “Immunosuppression”, which is a deliberate weakening of the immune system and thus can not attack the transplanted organ. This is because the foreign body and the immune system would not normally be challenged and thus there would be destruction. On the other hand, the risk of immunosuppression, higher susceptibility to infections and serious course of infectious diseases. Thus, even if the cytomegalovirus, which is activated either in the weakening of the organism, or is often present even in a transplanted organ or Transfused blood. Then the disease can be severe, there are fever, decreased liver function and cytomegalovirus pneumonia (pneumonia) can be fatal.

AIDS there is a dramatic loss of lymphocytes and thereby weakening the immune system.Cytomegalovirus infection in AIDS is the most common opportunistic infections (common infection that is harmless for healthy individuals, but with debilitating causes disease). The most common form in AIDS is retinitis (cytomegalovirus retinitis), may also be affected spinal nerve roots(polyradiculopathy), manifested most flaccid paralysis (paralysis) of the limbs and problems of their sensitivity, a painful inflammation of the peripheral nerves (neuropathy). If the affected digestive tract is affected by pain and difficulty in swallowing due to ulcers in the wall of the esophagus, colon inflammation (colitis) suffering from diarrhea. Furthermore cytomegalovirus can causeinflammation of the pancreas (acute pancreatitis) or gallbladder (cholecystitis).

Another serious problem is cytomegalovirus infection during pregnancy. Sometimes occurs during pregnancy, most commonly in the last trimester, the reactivation of latent infection and thus often to infect the fetus during labor. In healthy term infants without symptoms of infection mostly takes place. In children prematurity or immunocompromised however cause various diseases, such as pneumonia, gastrointestinal tract diseases or sepsis (severe systemic symptoms). Fortunately, when the reactivation of latent infection is likely the fetus is relatively malá- about 1%.

What but fear most is a primary infection during pregnancy, which is most dangerous during the first trimester and more than 10% of cases can cause serious damage to the fetus. Fetal infection is called so. “Innate, congenital infection.” If confirmed, it is recommended to abortion. Congenital infection may manifest itself death of fetus, the creation of congenital malformations of the brain, heart and eye, hearing impairment and mental retardation (overall slowdown in development).Furthermore, the overall infection of the newborn, which has resulted in low birth weight, jaundice, anemia, bleeding manifestations, liver and spleen enlargement, inflammation of the lungs. Alarming are the results of recent studies that have shown that about a third of women in our country have created antibodies against cytomegalovirus, and therefore they threatened the above-described risks.

Prevention of CMV infection

Prevention is the strict observance of standard hygienic principles, investigation of blood donation and organ transplantation and donation excluded from an infected donor especially in non-immune recipients. Pregnant woman with primary CMV infection is recommended to interrupt the pregnancy. Vaccination is not yet, but the clinical study.

Treatment of Cytomegalovirus Infection

Cytomegalovirus infection in healthy individuals usually do not require treatment with, we treat only the symptoms of the possible, as with other viral infections. In children and debilitated individuals used antiviral drugs, mostly ganciclovir. Vaccines are under development.

How do I help myself

While the disease is necessary to observe sufficient fluid intake if high fever, can be reduced by applying cold compresses to the armpits and groin. It should be appreciated that the elevated temperature is a response to infection and aids in the destruction of the virus, so it is not necessary if the temperature is too high, try it at all costs decrease.

Complications of CMV infection

Primary cytomegalovirus infection may sometimes even in healthy people cause a condition similar to infectious mononucleosis syndrome (infectious mononucleosis, cytomegalovirus mononucleosis), manifested fever, swollen lymph nodes, and blood count. Unlike right mononucleosis (caused by Epstein-Barr virus) are not coated with white almonds and blood lacking specific antibody. They can be affected by the liver (hepatitis) and therefore monitoring is recommended in hepatic counseling.

Other complications include pneumonia (interstitial pneumonitis), followed syndrome Guillian-Barré syndrome (inflammation of nerve roots, which is most often manifested disorders of sensitivity and movement of the limbs), meningitis and brain (encephalitis), inflammation of the heart (myocarditis) and skin infections.

In newborns or during cytomegalovirus mononucleosis may reduce platelet count (thrombocytopenia) and red blood cells (anemia).

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