Cytomegalovirus
(CMV) Infection

Cytomegalovirus (CMV) is a virus belonging to the herpes family.  The disease occurs worldwide and is transmitted by human contact.  About 80-85% of people over age 35 have been infected with cytomegalovirus, usually during childhood or early adulthood.  In most of these people, the disease is so mild that it's overlooked.  However, CMV infection during pregnancy can be hazardous to the fetus, possibly leading to stillbirth, brain damage, other birth defects, or neonatal illness.

Causes and Development; Contributing Risk Factors

Cytomegalovirus has been found in the saliva, respiratory droplets, urine, semen, breast milk, feces, blood (transfusions), and vaginal and cervical secretions of infected persons.  Transmission usually takes place through contact with these infected secretions, which harbor the virus for months or even years.

Cytomegalovirus is probably spread through the body in lymphocytes or mononuclear cells to the lungs, liver, and central nervous system where it often produces inflammatory reactions.

Immunodeficient patients (AIDS patients or who have those who have received transplanted organs), are at high risk of contracting CMV infection.  Recipients of blood transfusions from donors with positive CMV antibodies are at some risk.

Signs and Symptoms

As with EBV, CMV is frequently symptomless.

Treatment and Prevention

There is no specific treatment available; antiviral medications do not help.  Relief of symptoms is provided with analgesics, and warm salt water gargles for sore throat.

Prognosis; Complications

In most patients, the disease usually runs a benign, self-limiting course.  Most patients recover within 4 to 6 weeks without medication.  Fever usually resolves in around 10 days, and swollen lymph glands and spleen return to normal in 4 weeks.  Fatigue may linger for 2 to 3 months.

As with EBV, mono most often results when CMV infection occurs in the teens and 20s.  Immunodeficient patients and those receiving immunosuppressives may develop pneumonia or other secondary infections.  Other possible complications include secondary throat infection, rupture of spleen (rare) and neurologic complications (rare).