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Pathology

Cytomegalovirus is a member of the Herpes virus family of DNA viruses. Incubation 3-12 weeks.

Aetiology

Shedding in secretions (saliva, urine, respiratory, genital and breast milk). Crosses placenta giving rise to congenital infection, usually in primary maternal infection. 

Signs

Lymphadenopathy is seen in 15% in contrast to EBV infection

Symptoms

Majority asymptomatic; may have fever 3-5 weeks, profuse sweats, lethargy.

Investigations

Bloods: FBC, LFTs
Microbiology: CMV PCR
Histology: Owl-eye nuclei (prominent nucleoli and intracytoplasmic inclusions).

Treatment

Conservative: Supportive treatment. 
Anti-Virals: For immunocompromised hosts or in complicated infection

Prognosis

Generally very good
Hepatitis, myocarditis, meningoencephalitis, thrombocytopenia, haemolytic anaemia, Guillain-Barré syndrome, retinitis.

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Key References

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