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Cytomegalovirus (CMV) infection

CMV mononucleosis; Cytomegalovirus; CMV; Human cytomegalovirus; HCMV

Cytomegalovirus (CMV) infection is a disease caused by a type of herpes virus.

Causes

Infection with CMV is very common. The infection is spread by:

  • Blood transfusions
  • Organ transplants
  • Respiratory droplets
  • Saliva
  • Sexual contact
  • Urine
  • Tears

Most people come into contact with CMV in their lifetime. But usually, it's people with a weakened immune system, such as those with HIV/AIDS, who become ill from CMV infection. Some otherwise healthy people with CMV infection develop a mononucleosis-like syndrome.

CMV is a type of herpes virus. All herpes viruses remain in your body for the rest of your life after infection. If your immune system becomes weakened in the future, this virus may have the chance to reactivate, causing symptoms.

Symptoms

Many people are exposed to CMV early in life, but do not realize it because they have no symptoms, or they have mild symptoms that resemble the common cold. These may include:

CMV can cause infections in different parts of the body. Symptoms vary depending on the area that is affected. Examples of body areas that can be infected by CMV are:

Exams and Tests

Your health care provider will perform a physical exam and feel your belly area. Your liver and spleen may be tender when they are gently pressed (palpated). You may have a skin rash.

Special lab tests such as a CMV DNA serum PCR test may be done to check for presence of substances in your blood produced by CMV. Tests, such as a CMV antibody test, may be done to check the body's immune response to the CMV infection.

Other tests may include:

Treatment

Most people recover in 4 to 6 weeks without medicine. Rest is needed, sometimes for a month or longer to regain full activity levels. Painkillers and warm salt-water gargles can help relieve symptoms.

Antiviral medicines are usually not used in people with healthy immune function.

Outlook (Prognosis)

Outcome is good with treatment. The symptoms may be relieved in a few weeks to months.

Possible Complications

Throat infection is the most common complication. Rare complications include:

When to Contact a Medical Professional

Call for an appointment with your provider if you have symptoms of CMV infection.

Go to the emergency room or call the local emergency number (such as 911) if you have sharp, severe sudden pain in your left upper abdomen. This could be a sign of a ruptured spleen, which may require emergency surgery.

Prevention

CMV infection can be contagious if the infected person comes in close or intimate contact with another person. You should avoid kissing and sexual contact with an infected person.

The virus may also spread among young children in day care settings.

When planning blood transfusions or organ transplants, the CMV status of the donor can be checked to avoid passing CMV to a recipient who has not had CMV infection.

References

Centers for Disease Control and Prevention website. Cytomegalovirus (CMV) and congenital CMV infection. www.cdc.gov/cmv/clinical/index.html. Updated June 6, 2018. Accessed October 8, 2018.

Crumpacker CS. Cytomegalovirus (CMV). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition. 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 140.

Drew WL. Cytomegalovirus. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 376.

    • Mononucleosis - photomicrograph of cells

      Mononucleosis - photomicrograph of cells - illustration

      This so-called Downy cell is typical of lymphocytes infected by EBV (Epstein Barr Virus) or CMV (Cytomegalovirus) in infectious mononucleosis. Downy cells may be classified as types I, II, or III. This is a type II Downy cell.

      Mononucleosis - photomicrograph of cells

      illustration

    • Mononucleosis - photomicrograph of cells

      Mononucleosis - photomicrograph of cells - illustration

      This is a lymphocyte that has been infected by the Epstein-Barr Virus (EBV) or Cytomegalovirus (CMV) in infectious mononucleosis and is referred to as a Downy cell. Downy cells may be classified as types I, II, or III. this is a type I Downy cell.

      Mononucleosis - photomicrograph of cells

      illustration

    • Infectious mononucleosis #3

      Infectious mononucleosis #3 - illustration

      Infectious mononucleosis is caused by the Epstein-Barr virus. It is a viral infection causing high temperature, sore throat, and swollen lymph glands. Infectious mononucleosis can be contagious if the infected person comes in close or intimate contact with another person through saliva or sexual contact.

      Infectious mononucleosis #3

      illustration

    • Mononucleosis infecciosa

      Mononucleosis infecciosa - illustration

      Swollen lymph nodes, sore throat, fatigue and headache are some of the symptoms of mononucleosis, which is caused by the Epstein-Barr virus. It is generally self-limiting and most patients can recover in 4 to 6 weeks without medicines.

      Mononucleosis infecciosa

      illustration

    • Mononucleosis - photomicrograph of cell

      Mononucleosis - photomicrograph of cell - illustration

      This picture shows large, atypical lymphocytes (white blood cells). These cells are seen in viral infections, most commonly caused by the Epstein-Barr virus (infectious mononucleosis), cytomegalovirus diseases, and occasionally infectious hepatitis. This is an example of a type I Downy cell.

      Mononucleosis - photomicrograph of cell

      illustration

    • Mononucleosis - mouth

      Mononucleosis - mouth - illustration

      Infectious mononucleosis is caused by the Epstein-Barr virus. In teenagers and young adults, there is frequently a sore throat and red tonsils with whitish spots (exudate), as seen in this picture. Enlarged lymph nodes and fatigue are also common.

      Mononucleosis - mouth

      illustration

    • Antibodies

      Antibodies - illustration

      Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.

      Antibodies

      illustration

      • Mononucleosis - photomicrograph of cells

        Mononucleosis - photomicrograph of cells - illustration

        This so-called Downy cell is typical of lymphocytes infected by EBV (Epstein Barr Virus) or CMV (Cytomegalovirus) in infectious mononucleosis. Downy cells may be classified as types I, II, or III. This is a type II Downy cell.

        Mononucleosis - photomicrograph of cells

        illustration

      • Mononucleosis - photomicrograph of cells

        Mononucleosis - photomicrograph of cells - illustration

        This is a lymphocyte that has been infected by the Epstein-Barr Virus (EBV) or Cytomegalovirus (CMV) in infectious mononucleosis and is referred to as a Downy cell. Downy cells may be classified as types I, II, or III. this is a type I Downy cell.

        Mononucleosis - photomicrograph of cells

        illustration

      • Infectious mononucleosis #3

        Infectious mononucleosis #3 - illustration

        Infectious mononucleosis is caused by the Epstein-Barr virus. It is a viral infection causing high temperature, sore throat, and swollen lymph glands. Infectious mononucleosis can be contagious if the infected person comes in close or intimate contact with another person through saliva or sexual contact.

        Infectious mononucleosis #3

        illustration

      • Mononucleosis infecciosa

        Mononucleosis infecciosa - illustration

        Swollen lymph nodes, sore throat, fatigue and headache are some of the symptoms of mononucleosis, which is caused by the Epstein-Barr virus. It is generally self-limiting and most patients can recover in 4 to 6 weeks without medicines.

        Mononucleosis infecciosa

        illustration

      • Mononucleosis - photomicrograph of cell

        Mononucleosis - photomicrograph of cell - illustration

        This picture shows large, atypical lymphocytes (white blood cells). These cells are seen in viral infections, most commonly caused by the Epstein-Barr virus (infectious mononucleosis), cytomegalovirus diseases, and occasionally infectious hepatitis. This is an example of a type I Downy cell.

        Mononucleosis - photomicrograph of cell

        illustration

      • Mononucleosis - mouth

        Mononucleosis - mouth - illustration

        Infectious mononucleosis is caused by the Epstein-Barr virus. In teenagers and young adults, there is frequently a sore throat and red tonsils with whitish spots (exudate), as seen in this picture. Enlarged lymph nodes and fatigue are also common.

        Mononucleosis - mouth

        illustration

      • Antibodies

        Antibodies - illustration

        Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.

        Antibodies

        illustration

      Review Date: 9/22/2018

      Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

      The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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