Cytomegalovirus infection (CMV) is a chronic disease, the causative agent of which belongs to the herpes family. Pathology can proceed both asymptomatically and significantly worsen the well-being and quality of life of a person, affecting the internal organs and the central nervous system. According to statistics, almost half of the world's population are carriers of the virus. At the same time, most people are not even aware of its presence.
What is this?
CMV infection is a disease, the development mechanism of which is as follows: a virus containing DNA molecules enters the human body and inserts its genome into 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 cytomegalic, and they themselves begin to produce the virus. Due to this, there is a violation of energy and synthetic processes. Unlike othersviruses belonging to the herpes family, this pathogen has a rather long process of replication (reproduction), which prevents the formation of stable immunity.
You can only get infected from a sick person. It is important to know that in the body of both women and men, CMV infection remains forever. In the dormant form, it does not manifest itself in any way and does not have a negative impact. 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.
Routes of infection
Cytomegaly is not highly contagious. In order for the virus to be transmitted from a sick person to a he althy person, it is necessary to have long and close contact with the carrier of the infection.
You can get infected in the following ways:
- Airborne (when talking, sneezing, coughing or kissing).
- Sexual (during sexual contact, the virus is contained in the female secretion and in the semen of men).
- Hemotransfusion (during the transfusion of blood or its components, as well as during tissue and organ transplantation).
- Transplacental (during pregnancy from mother to child).
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 an 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 processdiagnosis is detected (along with CMV infection) EBV - Epstein-Barr virus. It also belongs to the herpes family and has no negative effect on 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:
- Innate. 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 may occur. In addition, there are signs of disorders of the central nervous system.
- Spicy. It is characterized by the presence of symptoms similar to those of a common cold. Also on the tongue and gums of the patient, you can notice a white coating.
- 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 diagnostic process.
Currently, it is extremely difficult to determine the duration of the course of CMV infection. The latent form is conditionally designated as an interval of 1-2 months, since it is impossible to determine the initial moment of the development of the disease.
Medics identify several possible options for the development of pathology, each of which is characterized by a certain set of features:
- The transition to the active phase occurs during normalfunctioning of the body's defense system. It should be noted that such cases are extremely rare. The development of the disease is accompanied by fever, muscle weakness, deterioration in general well-being. In addition, a person's lymph nodes are enlarged. 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 have suffered an acute phase of CMV infection, attributing everything to a cold.
- The disease becomes active when the immune system is weakened. In such cases, they speak of a generalized form of the disease. Pathology manifests itself in the defeat of the pancreas, liver, kidneys, lungs and retina. Most often it occurs in people with severe immunodeficiency, leukemia, hemoblastosis, as well as in those who have recently undergone transplantation of any internal organ.
- Symptoms appear shortly after the birth of a child who was infected in utero. Signs of CMV infection in this case are: a delay in physical development, a violation of the formation of the jaws, poor hearing and vision. In addition, there is an increase in internal organs (usually the spleen, liver or kidneys).
In males, the infection in most cases is in a dormant 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:
- increasedbody temperature;
- chill;
- nasal congestion;
- headache;
- rash;
- inflammatory processes in the joints.
Thus, the manifestations of the infection are similar to those 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, symptoms bother a person for about 1 month.
Diagnosis
If you experience anxiety symptoms, you should consult a therapist. If a specialist suspects the presence of cytomegalovirus, he will refer you to a venereologist or dermatovenereologist for a consultation.
During the appointment, the doctor conducts an initial diagnosis of CMV infection, including a survey and examination. The specialist needs to provide information regarding the symptoms present and how long ago they occurred. After that, the doctor evaluates the condition of the skin and palpates the internal organs to detect their increase in size.
If a cytomegalovirus infection is suspected, the specialist issues a referral for the following laboratory tests:
- Cultural sowing. Biomaterial can be blood, urine, urogenital swab, saliva or semen. During the study, it is possible not only to identify 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 also informative for individuals who have both CMV and HSV infection (herpes simplex virus).
- Light microscopy. The essence of the method lies in a thorough study of the biomaterial, during which pathologically altered cells of huge sizes with specific intranuclear inclusions are detected.
- Immunoassay. This is a blood test that detects antibodies to CMV infection. The method is not informative for immunodeficiency. This is due to the fact that in this condition, the process of producing antibodies does not occur.
- DNA diagnostics. The study of the biomaterial is carried out in order to detect these molecules. The disadvantage of the method is that it detects only the presence of an infection, and it is impossible to obtain information regarding the degree of activity with its help.
As a rule, doctors prescribe several types of research 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 only be provided by a physician based on diagnostic results.
Currently, there are no drugs whose action can completely rid the body of the pathogen. According to the guidelines, uncomplicated CMV infection 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 litersclean non-carbonated water per day.
In most cases, the treatment of CMV infection in adults is carried out with the drug "Ganciclovir". This is an antiviral agent that is prescribed only when the immune system is weakened. 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 drug "Foscarnet" showed the greatest efficiency. But it can also cause serious complications and should therefore be taken with caution and according to a strict regimen prescribed by a physician.
There is no diet or daily routine required during treatment.
Cytomegalovirus infection during pregnancy
During the period of bearing a child, the disease poses a danger to the fetus. In some cases, it serves as an indication for artificial termination of pregnancy. The most serious consequences are observed during primary infection. This is due to the fact that in the mother's body there are no antibodies to the pathogen. You need to know that CMV infection in women is an ailment that is transmitted at the time of conception, through the placenta and during delivery. In addition, the pathogen enters the baby's body along with breast milk.
CMV infection during pregnancy can provoke intrauterine death of the child, especially in the first trimester. If the gestational period is completed successfully, they speak of a congenital form of the disease. In this case, the symptoms in the infant appear immediately or after2-5 years.
However, one should not think that CMV infection in women is such a pathology that is a sentence. Currently, pregnant women at risk are given special attention. With the timely provision of medical care, the likelihood of a he althy baby is significantly increased.
In order to prevent infection, a pregnant woman is advised to avoid crowds. If it does, the following symptoms occur:
- general weakness;
- slight increase in body temperature;
- feeling of aching muscles and joints.
In many cases, the course of the disease is not accompanied by any warning signs. As a rule, pathology is detected in the process of standard diagnostics.
Treatment of CMV infection in pregnant women involves taking antiviral and immunomodulating agents. If a woman is a carrier of a pathogen that is in an inactive phase, therapy is not required. But in this case, she needs to monitor her he alth and avoid situations that weaken the body's defenses.
Cytomegalovirus infection in children
In most cases, infection occurs in utero. At the same time, only about 17% of the pathogen manifests itself with various signs.
Symptoms of CMV infection in children are:
- jaundice;
- enlargement of the liver and spleen in size;
- low hemoglobin level;
- roster changeblood;
- disturbances in the work of the central nervous system;
- lesion of the visual system and hearing apparatus;
- rashes on the skin;
- presence of liquid connective tissue in the feces.
In severe cases, the vital activity of pathogenic microorganisms negatively affects the brain. At the same time, the child has convulsions, and 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 regularly examined by a doctor to prevent the occurrence of various complications.
In the acquired form of the disease (for example, if the infection occurred in a kindergarten through saliva on toys), the following symptoms appear:
- high body temperature;
- enlarged lymph nodes;
- chill;
- runny nose;
- drowsy.
In addition, the endocrine and respiratory systems are often affected.
Treatment of CMV infection in children involves taking antiviral and immunomodulating agents.
Possible Complications
The negative consequences of the disease are very diverse. The most commonly diagnosed disorders in patients are:
- hepatitis;
- gastric and duodenal ulcer;
- esophagitis;
- pancreatitis;
- diabetes mellitus;
- significant deterioration of vision up to its complete loss;
- reducedblood pressure;
- anorexia;
- hyperpigmentation of the skin;
- mental and neurological disorders;
- deafness;
- pathology of the cardiovascular system.
The above disorders are only a part of the possible 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 to timely detect the transition of the pathogen into the active phase.
Prevention
Currently, there is no vaccine that would reliably protect a person from infection. In addition, standard measures (such as good personal hygiene) also do not reduce the chance of infection.
The issue of prevention in relation to persons at risk is extremely acute. To reduce the likelihood of infection, they are prescribed immunomodulators and antiviral drugs. In addition, women planning pregnancy should undergo a thorough examination.
In conclusion
Cytomegalovirus infection is a chronic disease. Its causative agent belongs to the herpes family and, when it enters the human body, remains in it forever. With strong immunity, the pathogen does not affect the functioning of internal organs and systems. Activation of the infection occurs with a significant weakening of the body's defenses.
Currently, there is no treatment that can completely get rid of CMVinfections. The aim 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.
