Cytomegalovirus infection (CMV) is a disease of a chronic nature, the causative agent of which belongs to the herpes family. Pathology can occur both asymptomatically and significantly worsen the well-being and quality of life of a person, affecting the internal organs and central nervous system. According to statistics, almost half of the world's population are carriers of the virus. Moreover, most people do not even suspect its presence.
What it is?
CMV infection is a disease whose development mechanism is as follows: a virus containing DNA molecules penetrates the human body and embeds its genome in the host cells. As a result of this process, the process of their pathological change is launched. The affected cells increase in size, that is, they become cytomegal, and they themselves begin to produce the virus. Due to this, there is a violation of energy and synthetic processes. Unlike other viruses belonging to the herpes family, this pathogen has a rather long process of replication (reproduction), which prevents the formation of persistent immunity.
You can get infected only from a sick person. It is important to know that in the body of both women and men, CMV infection remains forever. In a sleeping form, it does not manifest itself in any way and does not have a negative effect. The transition to the acute phase occurs when the body's defenses are weakened.
In the International Classification of Diseases (ICD-10), CMV infection is assigned the code B25.
Infection pathways
The degree of contagion of cytomegaly is not high. In order for the virus to be transmitted from a sick person to a healthy one, it is necessary to contact the carrier of the infection for a long time and closely.
You can get infected in the following ways:
- Airborne (during a conversation, while sneezing, coughing or kissing).
- Sexually (during sexual contact, the virus is contained in a female secret and in semen in men).
- Blood transfusion (during transfusion of blood or its components, as well as transplantation of tissues and organs).
- Transplacental (during pregnancy from mother to baby).
When CMV enters the body, the infection does not cause any symptoms only if the person has high immunity. In this case, the pathogen is found in the biomaterial of the infected person. As soon as the body's defenses are weakened, the disease can go into an active form. Most often in a person in the process of diagnosis is detected (along with CMV infection) EBV - Epstein-Barr virus. It also belongs to the herpes family and does not adversely affect high immunity.
Symptoms
CMV infection is persistent, that is, of a chronic nature. It is characterized by a variety of clinical manifestations, the severity of which depends on the form of pathology.
Specialists divide CMV infection into the following types:
- Congenital. The main symptom of the disease is an increase in the size of the spleen and liver. Against the background of the development of the disease, jaundice and internal bleeding can occur. In addition, signs of malfunctioning of the central nervous system appear.
- Sharp. It is characterized by the presence of symptoms similar to the manifestations of a common cold. Also on the patient’s tongue and gums, a white coating can be noticed.
- Generalized. It is characterized by the development of inflammatory processes in the pancreas, kidneys and adrenal glands, spleen. As a rule, a bacterial infection is also detected during the diagnosis process.
At present, it is extremely difficult to determine the duration of the course of CMV infection. The latent form is conventionally indicated by an interval of 1-2 months, since it is impossible to determine the initial moment of the development of the disease.
Doctors distinguish several possible options for the development of pathology, each of which is characterized by a certain set of signs:
- The transition to the active phase occurs during the normal functioning of the body's defense system. It is worth noting that such cases are extremely rare. The development of the disease is accompanied by fever, muscle weakness, and a deterioration in overall well-being. In addition, a person has enlarged lymph nodes. In most cases, the disease goes away on its own, which is a consequence of the powerful work of the body's defenses. As a rule, people do not even realize that they suffered the acute phase of CMV infection, attributing everything to the common cold.
- The disease becomes active when the immune system is weakened. In such cases, they talk about a generalized form of the disease. Pathology is manifested in damage to the pancreas, liver, kidneys, lungs and retina. Most often, it occurs in individuals with severe immunodeficiency, leukemia, hemoblastosis, as well as in those who have recently undergone an organ transplant surgery.
- Symptoms appear shortly after the birth of a baby who has been infected in utero. Signs of CMV infection in this case are: a delay in physical development, impaired jaw formation, poor hearing and vision. In addition, there is an increase in internal organs (usually the spleen, liver or kidneys).
In males, the infection is in most cases in a sleeping form. The transition to the active phase is carried out with a significant weakening of the body's defenses, which is the result of a cold or prolonged exposure to stress.
Symptoms of infection in men are:
- fever;
- chills;
- nasal congestion;
- headache;
- rash;
- inflammatory processes in the joints.
Thus, the manifestations of infection are similar to the signs of acute respiratory infections and acute respiratory viral infections. The fundamental difference from colds is the duration of the preservation of the clinical picture. With cytomegaly, the symptoms worry the person for about 1 month.
Diagnostics
If disturbing symptoms occur, consult a physician. If a specialist suspects the presence of cytomegalovirus, he will be referred for consultation by a venereologist or dermatovenerologist.
In the process of admission, the doctor conducts an initial diagnosis of CMV infection, including a survey and examination. The specialist must provide information on the symptoms that are present and how long they have arisen. After that, the doctor assesses the condition of the skin and carries out palpation of the internal organs in order to detect their increase in size.
If a cytomegalovirus infection is suspected, the specialist draws up a referral to the following laboratory tests:
- Cultural sowing. Blood, urine, urogenital smear, saliva or sperm can serve as biomaterial. During the study, it is possible not only to detect CMV infection in adults and children, but also to understand what degree of activity the disease has. In addition, this analysis is also prescribed after the course of treatment. With its help it is possible to evaluate the effectiveness of the prescribed therapeutic regimen. The study is informative in relation to persons with both CMV and HSV infection (herpes simplex virus).
- Light microscopy. The essence of the method is a thorough study of biomaterial, during which pathologically altered cells of huge sizes with specific intranuclear inclusions are detected.
- Enzyme immunoassay. This is a blood test in which antibodies to CMV infection are detected. The method is not informative for immunodeficiency. This is due to the fact that in this condition the process of antibody production does not occur.
- DNA diagnostics. The study of biomaterial is carried out in order to detect these molecules. The disadvantage of this method is that it only detects the presence of infection, and it is impossible to obtain information on the degree of activity with its help.
As a rule, doctors prescribe several types of studies at once. This is because the disease can take various forms, and one method is not enough to make an accurate diagnosis.
Conservative therapy
Information on how to treat CMV infection should be provided only by a doctor based on the diagnostic results.
Currently, there are no drugs whose action is able to completely rid the body of the pathogen. According to the guidelines, CMV infection in uncomplicated form does not require treatment. In other cases, it is aimed at getting rid of unpleasant symptoms. To eliminate intoxication, it is necessary to consume at least 2.5 liters of pure still water per day.
In most cases, treatment of CMV infection in adults is carried out with the drug Ganciclovir. This is an antiviral agent that is prescribed only for weakened immunity. It is available in the form of tablets and solution. Injections are indicated for patients with severe forms of the disease.
In the treatment of pathology in people with immunodeficiency, the Foskarnet drug was most effective. But it is also capable of causing serious complications, in connection with which it should be taken with caution and in a strict manner drawn up by the doctor.
During treatment, you do not need to adhere to any diet or a specific daily regimen.
Cytomegalovirus infection during pregnancy
During the period of gestation, the disease is a danger to the fetus. In some cases, it serves as an indication for artificial termination of pregnancy. The most serious consequences are noted with primary infection. This is because in the mother's body there are no antibodies to the pathogen. It is necessary to know that CMV infection in women is such an ailment that is transmitted at the time of conception, through the placenta and during delivery. In addition, the pathogen enters the body of the baby along with breast milk.
CMV infection during pregnancy can trigger intrauterine death of a child, especially in the first trimester. If the gestational period ends successfully, they speak of a congenital form of the disease. In this case, the symptoms in the baby appear immediately or after 2-5 years.
Nevertheless, you should not think that CMV infection in women is a pathology that is a sentence. Currently, pregnant women at risk are given special attention. With the timely provision of medical care, the likelihood that the child will be born healthy increases significantly.
In order to prevent infection, a pregnant woman is advised to avoid crowding. If it happened, the following symptoms occur:
- general weakness;
- a slight increase in body temperature;
- sensation of aches in muscles and joints.
In many cases, the course of the disease is not accompanied by the appearance of any alarming signs. As a rule, pathology is detected in the process of standard diagnostics.
Treatment of CMV infection in pregnant women involves the use of antiviral and immunomodulating agents. If a woman is a carrier of a pathogen in an inactive phase, therapy is not required. But in this case, she needs to monitor her health and avoid situations that cause the body's defenses to weaken.
Cytomegalovirus infection in children
In most cases, infection occurs in utero. However, only about 17% of the pathogen is manifested by various signs.
Symptoms of CMV infection in children are:
- jaundice;
- enlargement of the liver and spleen in size;
- low hemoglobin level;
- change in blood composition;
- disorders in the central nervous system;
- damage to the visual system and hearing system;
- rashes on the skin;
- the presence in the stool of an admixture of liquid connective tissue.
In severe cases, the vital activity of pathogenic microorganisms adversely affects the brain. At the same time, the child has convulsions, and the hands often tremble.
Shortly after birth, the baby's blood is taken for analysis. The presence of antibodies in it does not mean that the child may develop an acute form of the disease. Children with an identified infection should be examined regularly by a doctor to prevent the occurrence of various complications.
With the acquired form of the disease (for example, if the infection occurred in kindergarten through saliva on toys), the following symptoms appear:
- fever;
- enlarged lymph nodes;
- chills;
- runny nose;
- drowsiness.
In addition, the endocrine and respiratory systems are often affected.
Treatment of CMV infection in children involves the use of antiviral and immunomodulating agents.
Possible complications
The negative consequences of the disease are very diverse. Most often, the following disorders are diagnosed in patients:
- hepatitis;
- gastric and duodenal ulcer;
- esophagitis;
- pancreatitis
- diabetes;
- significant visual impairment up to its complete loss;
- low blood pressure;
- anorexia;
- hyperpigmentation of the skin;
- mental and neurological disorders;
- deafness;
- pathology of the cardiovascular system.
The above disorders are only part of the potential complications. It is impossible to predict which organ will be affected. In this regard, if CMV infection is detected, the recommendations of the attending physician should be followed regularly. In addition, it is necessary to periodically donate blood for the timely detection of the transition of the pathogen to the active phase.
Prevention
Currently, there is no vaccine that would reliably protect a person from infection. In addition, standard measures (for example, careful personal hygiene) also do not reduce the likelihood of infection.
The issue of prevention is extremely acute for people at risk. To reduce the likelihood of infection, they are prescribed immunomodulators and antiviral drugs. In addition, women planning a pregnancy must undergo a thorough examination.
Finally
Cytomegalovirus infection is a chronic disease. Its causative agent belongs to the herpes family and, upon penetration into the human body, remains in it forever. With strong immunity, the pathogen does not affect the functioning of internal organs and systems. Activation of infection occurs with a significant weakening of the body's defenses.
Currently, there is no treatment method that can completely get rid of CMV infection. The goal of therapy is to eliminate symptoms and prevent the development of complications. Treatment is with antiviral and immunomodulatory drugs. Compliance with standard preventive measures also does not reduce the risk of infection.