Cytomegalovirus infection is dangerous. Cytomegalovirus - symptoms, causes and treatment. Cytomegalovirus: consequences of a viral infection

Cytomegalovirus is quite widespread, antibodies of this virus are found in 10-15% of adolescents and young people. In people aged 35 years and over, it is found in 50% of cases. Cytomegalovirus is found in biological tissues - semen, saliva, urine, tears. When it enters the body, the virus does not disappear, but continues to live with its host.

What it is?

Cytomegalovirus (another name is CMV infection) is an infectious disease that belongs to the herpesvirus family. This virus infects a person both in utero and in other ways. So, cytomegalovirus can be transmitted sexually, by airborne droplets through the alimentary route.

How is the virus transmitted?

The routes of transmission of cytomegalovirus are diverse, since the virus can be found in blood, saliva, milk, urine, feces, seminal fluid, and cervical secretions. Possible airborne transmission, transmission by blood transfusion, sexual contact, possible transplacental intrauterine infection. An important place is occupied by infection during childbirth and when breastfeeding with the milk of a sick mother.

There are frequent cases when the carrier of the virus does not even suspect about it, especially in situations where the symptoms are almost not manifested. Therefore, you should not consider every carrier of cytomegalovirus as sick, since existing in the body, it may never manifest itself in a lifetime.

However, hypothermia and the subsequent decrease in immunity become factors provoking cytomegalovirus. Symptoms of the disease are also manifested due to stress.

Cytomegalovirus igg antibodies detected - what does this mean?

IgM are antibodies that the immune system begins to produce 4-7 weeks after a person is first infected with cytomegalovirus. Antibodies of this type are also produced every time when the cytomegalovirus, which has remained in the human body after a previous infection, begins to multiply actively again.

Accordingly, if a positive (increased) titer of IgM antibodies against cytomegalovirus was detected in you, then this means:

• that you have recently been infected with cytomegalovirus (not earlier than within the last year);
• That you were infected with cytomegalovirus for a long time, but recently this infection began to multiply again in your body.

A positive titer of IgM antibodies can persist in human blood for at least 4-12 months after infection. Over time, IgM antibodies disappear from the blood of a person infected with cytomegalovirus.

Development of the disease

The incubation period is days, acute for 2-6 weeks after the incubation period. Being in the body in a latent state both after infection and during periods of attenuation is an unlimited time.

Even after the course of treatment, the virus lives in the body for life, maintaining the risk of relapse, so doctors cannot guarantee the safety of pregnancy and full bearing even if a stable and prolonged remission occurs.

Symptoms of cytomegalovirus

Many people who are carriers of cytomegalovirus do not show any symptoms. Signs of cytomegalovirus may appear as a result of disorders in the immune system.

Sometimes in persons with normal immunity, this virus causes the so-called mononucleosis-like syndrome. It occurs a day after infection and lasts 2-6 weeks. It is manifested by high fever, chills, cough, fatigue, malaise and headache. Subsequently, under the influence of the virus, the body's immune system is restructured, preparing to repel the attack. However, in case of lack of strength, the acute phase passes into a calmer form, when vascular-vegetative disorders often appear, and internal organs are also damaged.

In this case, three manifestations of the disease are possible:

1. The generalized form is CMV damage to internal organs (inflammation of the liver tissue, adrenal glands, kidneys, spleen, pancreas). These organ damage can cause bronchitis, pneumonia, which further worsens the condition and puts increased pressure on the immune system. In this case, antibiotic treatment is less effective than with the usual course of bronchitis and / or pneumonia. At the same time, there may be a decrease in platelets in the peripheral blood, damage to the intestinal walls, blood vessels of the eyeball, brain and nervous system. Outwardly manifested, in addition to enlarged salivary glands, skin rash.
2. SARS - in this case, it is weakness, general malaise, headaches, runny nose, enlargement and inflammation of the salivary glands, fatigue, slightly elevated body temperature, whitish coatings on the tongue and gums; sometimes it is possible to have inflamed tonsils.
3. Damage to the organs of the genitourinary system - manifests itself in the form of periodic and non-specific inflammation. At the same time, as in the case of bronchitis and pneumonia, inflammation is difficult to treat with traditional antibiotics for this local disease.

Particular attention should be paid to CMVI in the fetus (intrauterine cytomegalovirus infection), in the newborn and young children. An important factor is the gestational period of infection, as well as the fact whether the infection of the pregnant woman occurred for the first time or the infection was reactivated - in the second case, the probability of infection of the fetus and the development of severe complications is much lower.

Also, in the case of infection of a pregnant woman, fetal pathology is possible, when the fetus becomes infected with CMV that enters the blood from outside, which leads to miscarriage (one of the most common causes). It is also possible to activate a latent form of the virus that infects the fetus through the mother's blood. Infection leads either to the death of the child in the womb / after childbirth, or to damage to the nervous system and brain, which manifests itself in various psychological and physical diseases.

Cytomegalovirus infection during pregnancy

When a woman is infected during pregnancy, in most cases she develops an acute form of the disease. Possible damage to the lungs, liver, brain.

The patient complains about:

• fatigue, headache, general weakness;
• increase and soreness when touching the salivary glands;
• discharge from the nose of a mucous nature;
• whitish discharge from the genital tract;
• abdominal pain (due to increased uterine tone).

If the fetus is infected during pregnancy (but not during childbirth), the development of congenital cytomegalovirus infection in a child is possible. The latter leads to severe diseases and lesions of the central nervous system (mental retardation, hearing loss). In 20-30% of cases, the child dies. Congenital cytomegalovirus infection occurs almost exclusively in children whose mothers first become infected with cytomegalovirus during pregnancy.

Treatment of cytomegalovirus during pregnancy includes antiviral therapy based on intravenous injection of acyclovir; the use of drugs for the correction of immunity (cytotect, intravenous immunoglobulin), as well as conducting control tests after the course of therapy.

Cytomegalovirus in children

Congenital cytomegalovirus infection is usually diagnosed in a child in the first month and has the following possible manifestations:

• cramp, trembling of the limbs;
• drowsiness;
• visual impairment;
• problems with mental development.

The manifestation is also possible at an older age, when the child is 3-5 years old, and usually looks like an acute respiratory disease (fever, sore throat, runny nose).

Diagnostics

Cytomegalovirus is diagnosed using the following methods:

Consequences

With a critical decrease in immunity and the inability of the body to produce an adequate immune response, cytomegalovirus infection becomes generalized and causes inflammation of many internal organs:

• adrenal glands;
• hepatic tissue;
• pancreas;
• kidneys;
• spleen;
• peripheral nervous tissue and the central nervous system.

Today, WHO puts the generalized form of cytomegalovirus infection in second place in terms of the number of deaths worldwide after acute respiratory infections and influenza.

Treatment of cytomegalovirus

In the event of activation of the virus, in no case should any self-treatment be carried out - this is simply unacceptable! Be sure to consult a doctor so that he prescribes the right therapy, which will include immunomodulatory drugs.

The most commonly used complex treatment of cytomegalovirus aimed at strengthening the immune system. It includes antiviral and restorative therapy. Associated diseases are also treated with antibiotics. All this allows the virus to be transferred to a latent (inactive) form, when its activity is controlled by the human immune system. However, there is no 100% method that would permanently eradicate the herpes virus from the body.

For example, according to serological tests, 90.8% of people in the group of 80 years and older are seropositive (that is, they have a positive level of IgG antibodies).

Prevention

Cytomegalovirus is especially dangerous during pregnancy, as it can provoke a miscarriage, stillbirth, or cause severe congenital deformities in a child.

Therefore, cytomegalovirus, along with herpes, toxoplasmosis and rubella, is one of those infections that women should be examined for prophylactically, even at the stage of pregnancy planning.

Which doctor should I contact?

Often, the gynecologist who observes the expectant mother deals with the diagnosis of CMV infection. If it is necessary to treat the disease, an infectious disease consultation is indicated. A newborn child with a congenital infection is treated by a neonatologist, then by a pediatrician, a neurologist, an ophthalmologist, and an ENT doctor observe.

In adults, when CMV infection is activated, it is necessary to consult an immunologist (often this is one of the signs of AIDS), a pulmonologist and other specialized specialists.

Consequences and complications of cytomegalovirus (CMV)

Cytomegalovirus is a dangerous disease that settles in the human body once and for all life. In medicine, methods have not yet been invented to completely cure the body of this insidious disease. Treatment consists only in keeping the virus in an inactive, safe state for the immune system.

The consequences of cytomegalovirus

CMV causes urinary tract infections in both men and women. An acute genital infection can lead to:

• to an increase in the spleen and liver;
• to inflammatory processes in the retina;
• to the appearance of an allergic rash all over the body;
• to the destruction of the central nervous system.

The consequences of cytomegalovirus are especially dangerous for a pregnant woman and her unborn child. The most critical situation is when a patient with an acute form of the disease transmits an infection to a pregnant woman. The virus freely crosses the placenta and infects the fetus. Subsequently, there is a threat of miscarriage, premature birth, the likelihood of a stillbirth. If a woman is infected with CMV long before conception, protective antibodies are produced in her body during pregnancy, which destroy the pathogens before they get to the fetus.

When infected with a virus in the initial trimesters of pregnancy, there is a high probability of its spontaneous interruption or the occurrence of abnormalities in the formation of the embryo. Infection in the later stages of bearing a child threatens him with dangerous consequences of cytomegalovirus: hearing loss, vision loss, mental retardation, epilepsy, cerebral palsy. Many infected infants die in the first months of their lives.

Congenital cytomegalovirus

The consequences of CMV are especially dangerous for patients with weak immunity, but in the case of a congenital infection, it can cause pathologies in newborns that are incompatible with a healthy life. External signs of the disease in an infected infant:

• dropsy;
• jaundice;
• pinpoint hemorrhages on the skin (petechiae);
• abnormal brain development, small head size (microcephaly);
• unnatural size of the liver and spleen.

Complications with cytomegalovirus

CMV can live in a person's body without showing any signs throughout his life. Complications of the disease usually occur in people with a weakened immune system and manifest themselves in the form of:

• sore throat, swelling of the tonsils and glands;
• diarrhea, inflammation of the colon, bloody stools;
• improper functioning of the liver;
• inflammation of the brain;
• pneumonia;
• sepsis;
• damage to internal organs.

If left untreated, the infection will further worsen the state of health, “roam” from organ to organ, and, as a result, the consequences of complications of cytomegalovirus can even lead to death.

The consequences of cytomegalovirus that you need to know about

CMV is an infectious disease belonging to the group of herpesviruses. Contains double-stranded DNA. The disease is called cytomegalovirus because when it enters a healthy cell, its size increases. If a person has good immunity, then the disease may be asymptomatic, but if there is a malfunction in the immune system, then a severe systemic infection may develop with damage to the kidneys, lungs, and the liver suffers.

The structure of CMV Cytomegalovirus is distributed throughout the globe and by the end of life, almost every person has it. It is impossible to remove it from the body, but its active properties can be reduced. CMV can be transmitted through saliva, milk during breastfeeding, sexual contact, through shared objects, from mother to child, as well as through contaminated blood transfusions or organ transplants. In pregnant women, it can cause damage to the fetus, since women do not have antibodies in the blood and the virus easily crosses the placenta. The entry gate for infection is the mucous membrane of the nose, mouth, digestive tract, genital tract and cervix. There are no changes at the site of infection.

Options for the course of CMV

cytomegalovirus infection in children With stable immunity in a patient, the infection proceeds according to the type of mononucleosis-like syndrome and then the virus is not very dangerous for the body. The prodromal period lasts an average of 20 to 60 days, the disease itself lasts about a month and a half, sometimes less. The patient has a slight increase in temperature, chills, weakness, muscle pain, lymph nodes may increase. The body produces antibodies to the virus, and self-healing occurs. But the pathogen is excreted from the body for a long time, up to several years after recovery. If the patient was first diagnosed with cytomegalovirus, then the disease has been in remission for a long time. Complications in this period are rare.

When the immune system is weakened, the infection generalizes, that is, the liver, lungs, kidneys are affected, vision is impaired, changes occur in all organs and systems.

Infection of a child during childbirth or in utero causes such consequences of cytomegalovirus as congenital cytomegaly, hearing loss, poor vision, and others. If infection of the fetus occurs before 12 weeks, spontaneous abortion usually occurs. Five percent of newborns have insufficient body weight, an increase in internal organs, and pneumonia may develop. If the child does not have cytomegaly, then he is threatened with mental retardation, visual impairment, hearing loss, and improper development of the teeth.

The consequences of cytomegalovirus

The appearance of complications with cytomegalovirus threatens those people who have a weakened immune system. On the part of the gastrointestinal tract, inflammation of the large intestine, diarrhea or constipation, blood in the stool, unreasonable fever, hepatitis develop, internal organs may not work properly.

• Complications from the nervous system are manifested by various neurological changes, inflammation of the brain (encephalitis).
• In the respiratory system - pneumonia (inflammation of the lung tissue) may appear.
• Women may have inflammation of the uterus (endometritis) or cervix (cervicitis), vagina (vaginitis), and other manifestations.
• If the nasal mucosa is damaged, the patient develops a runny nose, which is difficult to treat.
• HIV-infected people are more difficult to tolerate the disease, their general condition worsens, and they may die.

The fetus has such consequences of cytomegalovirus as a defect in the septum of the heart, narrowing of the pulmonary trunk, an abnormal structure of the kidneys, lungs, a defect in the development of the brain, microcephaly (small skull and small mass of the brain). When a woman becomes infected in late pregnancy, the child may have jaundice, mental changes, autism, impaired coordination of movement, convulsions in rare cases leading to death, visual impairment.

Cytomegaly in children

Cytomegaly Viral infectious disease with a large lesion of the parenchyma and salivary glands. Most often it happens in children under two years of age, if the child is premature or has a lack of body weight, then the virus is dangerous for him and causes severe generalized forms. When children are over two years old and they have a severe course of the disease and damage to all organs, this means that they have concomitant diseases (leukemia, HIV, sepsis, tumors). Cytomegalovirus, which infects the fetus, can lead to stillbirth. The virus leads to an increase in the cell, as a result of which the organs suffer. In children, a yellow skin color appears, the spleen enlarges, the size of the liver exceeds the norm, anemia in the blood (hemoglobin is low), the nervous system, organs of vision and hearing suffer.

Hemorrhagic rashes, infiltrates and foci of calcification appear on the skin, that is, whitish-yellow dense seals appear. After being involved in the pathological process of the brain, the child dies in a couple of weeks, the process is accelerated with concomitant HIV disease. In infants, the brain, as a rule, is not included in the pathological process.

Cervicitis as a consequence

Cytomegalovirus causes inflammation of the cervix and erosion of the cervix, up to the defeat of the appendages. Cervicitis in women is acute and is characterized by abundant purulent and mucous vaginal discharge. There is pain in the lower abdomen, constant pain, dull character. Complications arise with concomitant HIV. During a gynecological examination with the help of mirrors, hyperemia of the cervix is ​​noted, and erosion often occurs there. If the inflammation is not treated, then a painful thickening of the mucosa occurs, which is irritated by secretions and becomes erosive. And if the infection and the virus penetrate deeper, then the disease is aggravated and the appendages are involved in the process. All this further leads to infertility in women, since the fallopian tubes and its cavity itself are also infected.

After a complete examination and determination of the causes, antibiotic treatment is prescribed to eliminate inflammation, as well as drugs aimed at the cause of cervicitis (in this case, antiviral) and treatment of the consequences of cytomegalovirus, if it occurs.

Treatment of cytomegalovirus

The main task of the doctor treating cytomegalovirus is that he prescribes drugs that weaken the virus. There are five main treatment groups:

• antiviral agents, they block not only the virus, but also its reproduction in the body.
• immunostimulants to stimulate and strengthen the immune system.
• drugs for syndromic therapy for the restoration of infected organs and systems.
• symptomatic therapy stops all manifestations of the disease (painkillers, antipyretics, anti-inflammatory drugs, eye drops).

You can also use folk remedies to combat the symptoms of cytomegalovirus. If a complication occurs, it must be treated. Cytomegalovirus is usually treated in a hospital, especially in pregnant women and children, as well as in HIV-infected people and those who are immunocompromised due to specific therapy.

Why cytomegalovirus is dangerous: consequences and complications of infection

Cytomegalovirus is a latent virus found in the human body. Its main feature is that most people are unaware of the presence of infection.

According to medical examinations, 15-20% of adolescents and 60% of the population over 40 years of age are carriers of type 5 herpes.

Infection is dangerous because medicine at the present stage of development is not able to prevent infection with cytomegalovirus and help sick people.

The infection was discovered in the middle of the 20th century, so it has been little studied. CMV tends to spread safely around the world, and infects more and more people. This happens due to the fact that the virus is carefully hidden from the human immune system and makes itself felt only at the moment of deterioration in the general condition of the body.

Infection occurs through close contact with a carrier of the virus. After the initial infection, cytomegalovirus remains in the human body for the rest of life.

Why is cytomegalovirus dangerous?

CMV does not cause any harm to the health of people with strong immunity. A person can live for many years without knowing about the presence of this infection in the blood. However, the virus can be activated when the body's defenses are reduced. Penetrating into human cells, CMV significantly increases in size and changes the DNA of healthy cells. As a result, a disease of cytomegaly occurs, manifested in complications of varying severity.

Dangers for men

In the absence of harmful external factors (for example, work in a damp and cold room) and strong immunity, CMV is not dangerous for a man's health. The body will cope with the disease on its own by developing the necessary antibodies.

If the immune system of a man is weakened (against the background of ARVI or pneumonia, the presence of cancer, HIV infection, etc.), then a malfunction of the internal organs is possible:

1. Diseases of the genitourinary system, accompanied by pain during urination.
2. Pneumonia, myocarditis, encephalitis (in a critical case).
3. Paralysis and death (in very rare cases).

Treatment of cytomegalovirus in men should be aimed at eliminating the inflammatory process and keeping the virus in an inactive form.

What is the risk for women?

Cytomegalovirus for girls, as well as for men, is dangerous in case of reduced immunity. Infection can provoke the occurrence of various diseases:

• inflammation of the female genital organs;
• pleurisy, pneumonia;
• intestinal inflammation;
• hepatitis;
• neurological diseases (in extreme cases - encephalitis).

CMV is most dangerous for women during childbearing. Especially if the infection occurred in the first trimester of pregnancy. The virus can infect the fetus, and this will lead to the death of the embryo. At a later stage of pregnancy, the infection can have a negative impact on the formation of the internal organs of the baby. Therefore, it is important to check for infections when planning a pregnancy. In the presence of cytomegalovirus and antibodies to it in the body of a girl before pregnancy, a favorable outcome is most likely (the child will be a passive carrier of CMV).

For children

Many parents are wondering if cytomegalovirus is dangerous for a child? It depends on the type of infection and the age of the baby. The most dangerous consequences are revealed in the congenital form of the disease in a child under 1 year old:

• ulcers and wounds over the entire surface of the skin;
• disruption of the liver and spleen;
• bronchitis, pneumonia;
• jaundice.

If the baby acquired the virus during the first year of life, then the disease is milder. Symptoms are similar to SARS:

In older children, the disease is most often asymptomatic. Sometimes drowsiness and fever may occur. The disease in the acquired form rarely gives a complication to the health of the child.

Features of development and effect on the body

Cytomegalovirus is a fairly large virus (nm). Thanks to this, CMV got its name, literal translation, "giant cell". The virus enters a healthy cell and increases many times its size. The content of the cell is significantly reduced (sticks together), and the entire space is filled with liquid. Infected cells become large, stop dividing and die. In this case, inflammation of the surrounding tissues occurs.

Depending on the way CMV enters the human body, the degree of influence on internal systems depends:

• if the virus has penetrated through saliva, then the nasopharynx and bronchi suffer;
• with a lesion through the genital organs, the infection penetrates into the bladder, kidneys, uterus;
• in the blood, CMV damages leukocytes, lymphocytes, and then the centers of the spinal cord and brain.

However, a strong immune system quickly detects the virus and begins to fight it, forming antibodies. After that, the virus goes into a dormant form and remains in the human body forever.

Why carriers are dangerous

The source of infection of cytomegalovirus can be a patient with an active stage of the disease, and a person without any signs of infection. In a healthy body, antibodies begin to be produced after infection. This stage is called the latent period of the disease and lasts 4-8 weeks.

The most dangerous carrier of the virus during the incubation period of the disease, which begins after the latent stage and lasts from 15 to 60 days. During this period, the patient develops symptoms of the disease similar to SARS:

• chills;
• high body temperature;
• headache;
• runny nose;
• skin rash;
• malaise and fatigue.

At this stage, CMV multiplies very actively and the patient is dangerous to others. You can become infected through saliva and other secretions. However, this danger of infection extends to specific populations. First of all, the risk group includes people with reduced immunity:

• girls and their baby during pregnancy;
• preschool children;
• patients with oncology after courses of chemotherapy;
• people with HIV infection;
• patients after transplantation of donor organs.

For the rest of the population, carriers of cytomegalovirus do not pose a big threat.

Consequences of the virus after recovery

With timely treatment of CMV, significant consequences in the state of human health are not observed. In the acute form of the disease, the doctor usually prescribes antiviral and immunostimulating agents to the patient. If cytomegaly is asymptomatic, then there is no need for treatment.

Summing up, we can say that cytomegalovirus is dangerous for people with weakened immune systems. Because there are no medicines to fight the disease yet. But a person can always improve his health: go in for sports, harden, take vitamins in a complex. A strong immune system is the best cure for infections.

Cytomegalovirus infection: symptoms, diagnosis, treatment

Cytomegalovirus infection (CMVI, inclusive cytomegaly) is a very widespread viral disease, usually characterized by latent or mild course.

For an adult with normal immunity, the infectious agent does not pose a threat, but it can be deadly for newborns, as well as those with immunodeficiencies and transplant patients. often leads to intrauterine infection of the fetus.

Note: it is believed that the long-term persistence (survival in the body) of the virus is one of the reasons for the development of such oncological diseases as mucoepidermoid carcinoma.

CMV is found in all regions of the planet. According to statistics, it is present in the body of about 40% of people. Antibodies to the pathogen, indicating its presence in the body, are found in 20% of children of the first year of life, in 40% of people under the age of 35, and in almost every person aged 50 and older.

Although most infected people are latent carriers, the virus is by no means harmless. Its persistence negatively affects the immune system and in the long run often leads to increased morbidity due to reduced body reactivity.

It is currently impossible to completely get rid of cytomegalovirus, but it is quite possible to minimize its activity.

Classification

There is no single generally accepted classification. Congenital cytomegalovirus infection is conventionally divided according to the forms of the course into acute and chronic. Acquired CMVI can be generalized, acute mononucleosis or latent (without active manifestations).

Etiology and pathogenesis

The causative agent of this opportunistic infection belongs to the family of DNA-containing herpesviruses.

The carrier is a human, i.e. CMVI is an anthroponotic disease. The virus is found in the cells of a wide variety of organs rich in glandular tissue (which is the reason for the absence of specific clinical symptoms), but most often it is associated with the salivary glands (affects their epithelial cells).

Anthroponotic disease can be transmitted through biological fluids (including saliva, semen, cervical secretions). They can be contracted sexually, by kissing, and by sharing utensils or utensils. With an insufficiently high level of hygiene, the fecal-oral route of transmission is not excluded.

From mother to child, cytomegalovirus is transmitted during pregnancy (intrauterine infection) or through breast milk. There is a high probability of infection during transplantation or blood transfusion (blood transfusion) if the donor is a carrier of CMVI.

note: CMV infection was once commonly known as "kissing disease" because it was believed that the disease was transmitted exclusively through saliva during a kiss. Pathologically altered cells were first discovered during post-mortem tissue research at the end of the 19th century, and cytomegalovirus itself was isolated only in 1956.

Getting on the mucous membranes, the infectious agent penetrates through them into the blood. This is followed by a short period of viremia (the presence of the CMVI pathogen in the blood), which ends with localization. The target cells for cytomegalovirus are mononuclear phagocytes and leukocytes. In them, the process of replication of the DNA-genomic pathogen takes place.

Once in the body, cytomegalovirus, unfortunately, remains in it until the end of a person's life. An infectious agent can actively multiply only in some cells and under optimally suitable conditions. Due to this, with a sufficiently high level of immunity, the virus does not manifest itself in any way. But if the defenses are weakened, the cells, under the influence of an infectious agent, lose their ability to divide, and greatly increase in size, as if swelling (that is, cytomegaly itself takes place). A DNA-genomic virus (currently 3 strains have been discovered) is able to reproduce inside the “host cell” without damaging it. Cytomegalovirus loses its activity at high or low temperatures and is characterized by relative stability in an alkaline environment, but acidic (pH ≤3) quickly leads to its death.

Important: a decrease in immunity may be the result of AIDS, chemotherapy using cytostatics and immunosuppressants, carried out for oncological diseases, as well as conventional hypovitaminosis.

Microscopic examination reveals that the affected cells have acquired a characteristic "owl's eye" appearance. Inclusions (inclusions) are found in them, which are accumulations of viruses.

At the tissue level, pathological changes are manifested by the formation of nodular infiltrates and calcifications, the development of fibrosis, and infiltration of tissues by lymphocytes. Special glandular structures can form in the brain.

The virus is resistant to interferons and antibodies. The direct effect on cellular immunity is due to the suppression of the generation of T-lymphocytes.

Symptoms of cytomegalovirus infection

Certain clinical manifestations may occur against the background of primary or secondary immunodeficiencies.

Symptoms of cytomegalovirus infection are nonspecific, i.e., the disease can manifest itself in different ways, depending on which cells are predominantly affected.

In particular, with the defeat of the mucous membranes of the nose, nasal congestion appears and rhinitis develops. Active reproduction of cytomegalovirus in the cells of the organs of the gastrointestinal tract causes diarrhea or constipation; it is also possible the appearance of pain or discomfort in the abdominal region and a number of other unclear symptoms. Clinical manifestations of an exacerbation of CMVI, as a rule, disappear on their own after a few days.

note: an active infection can serve as a kind of "indicator" of the insolvency of cellular immunity.

Often, the virus can infect the cells of the mucous membranes of the organs of the genitourinary system.

Cytomegalovirus infection: symptoms in men

In men, the reproduction of the virus in the organs of the reproductive system in most cases does not manifest itself in any way, that is, we are talking about an asymptomatic course.

Cytomegalovirus infection: symptoms in women

In women, CMV infection is manifested by inflammatory diseases of the genital organs.

The following pathologies may develop:

• cervicitis (inflammatory lesions of the cervix);
• endometritis (inflammation of the uterine endometrium - the inner layer of the walls of the organ);
• vaginitis (inflammation of the vagina).

Important: in severe cases (usually at an early age or against the background of HIV infection), the pathogen becomes very active and spreads through the bloodstream to different organs, i.e., hematogenous generalization of the infection takes place. Multiple organ lesions are characterized by a severe course similar to sepsis. In such cases, the outcome is often unfavorable.

Involvement of the gastrointestinal tract leads to the development of ulcers, in which bleeding is frequent and perforations are not ruled out, resulting in life-threatening inflammation of the peritoneum (peritonitis). Against the background of acquired immunodeficiency syndrome, there is a possibility of subacute encephalopathy or chronic encephalitis (inflammation of the brain tissue). Damage to the central nervous system in a short time causes dementia (dementia).

Possible complications of CMV infection also include:

• vegetovascular disorders;
• inflammatory lesions of the joints;
• myocarditis;
• pleurisy.

In AIDS, cytomegalovirus in some cases affects the retina, causing gradually progressive necrosis of its areas and blindness.

Cytomegalovirus during pregnancy

Cytomegalovirus infection in women during pregnancy can cause intrauterine (transplacental) infection of the fetus, which does not exclude malformations. It should be noted that if the virus persists in the body for a long time, and, despite physiological immunosuppression, there are no exacerbations during gestation, then the likelihood that the unborn child will be harmed is extremely low. The probability of damage to the fetus is much higher if the infection occurred directly during pregnancy (infection in the first trimester is especially dangerous). Not excluded, in particular, prematurity and stillbirth.

In the acute course of CMVI in pregnant women, the following symptoms may appear:

• whitish (or bluish) discharge from the genitals;
• increased fatigue;
• general malaise;
• mucous discharge from the nasal passages;
• hypertonicity of the uterine muscles (resistant to drug therapy);
• polyhydramnios;
• early aging of the placenta;
• the appearance of cystic neoplasms.

Manifestations are often found in a complex. Placental abruption and very significant blood loss during labor are not excluded.

Possible fetal malformations in CMVI include:

• defects in the heart walls;
• atresia (infection) of the esophagus;
• anomalies in the structure of the kidneys;
• microcephaly (underdevelopment of the brain);
• macrogyria (pathological increase in the convolutions of the brain);
• underdevelopment of the respiratory system (lung hypoplasia);
• narrowing of the lumen of the aorta;
• clouding of the lens of the eye.

Intrauterine infection is noted even less often than intrapartum (when a child is born during passage through the birth canal).

During pregnancy, the use of immunomodulatory drugs - T-activin and Levamisole may be indicated.

Important: in order to prevent negative consequences, even at the stage of pregnancy planning and in the future, according to the recommendations of a gynecologist, a woman should be tested for TORCH infections.

Cytomegalovirus infection in children

CMV infection for newborns and young children poses a serious threat, since the immune system in babies is not completely formed, and the body is not able to adequately respond to the introduction of an infectious agent.

Congenital CMVI, as a rule, does not manifest itself in any way at the beginning of a baby's life, but the following are not excluded:

• jaundice of various origins;
• hemolytic anemia (anemia due to the destruction of red blood cells);
• hemorrhagic syndrome.

The acute congenital form of the disease in some cases leads to death in the first 2-3 weeks.

Over time, serious pathologies can develop, such as

• speech disorders;
• deafness;
• atrophy of the optic nerve against the background of chorioretinitis;
• decreased intelligence (with damage to the central nervous system).

Treatment of cytomegalovirus infection

Treatment of CMVI is generally ineffective. We are not talking about the complete destruction of the virus, but the activity of cytomegalovirus can be greatly reduced with the help of modern drugs.

The antiviral drug Ganciclovir is used to treat newborns for health reasons. In adult patients, it is able to slow down the development of retinal lesions, but with lesions of the digestive, respiratory and central nervous systems, it practically does not give a positive result. Cancellation of this drug often leads to recurrence of cytomegalovirus infection.

One of the most promising agents for the treatment of CMVI is Foscarnet. The use of specific hyperimmune immunoglobulin may be indicated. Interferons also help the body deal with cytomegalovirus faster.

A successful combination is Acyclovir + A-interferon. Ganciclovir is recommended to be combined with Amiksin.

The main symptoms and modern treatment of cytomegalovirus in women

Cytomegalovirus, or CMV infection, is a chronic disease with a high prevalence: antibodies to the pathogen are detected in 40% of the world's population. Although the virus persists for life in the human body, for most people it is not dangerous. A special category of patients are persons with reduced immunity, recurrent herpes and pregnant women. Generalization of infection in them can lead to serious health consequences. But how does cytomegalovirus manifest itself: we will talk about common symptoms of pathology in women in our review.

Epidemiology of CMVI

Cytomegalovirus infection is known worldwide. If in developed countries its prevalence is at the level of 30-35%, then in developing countries it often reaches 100%. Morbidity prevails among the fairer sex.

This is interesting. The causative agent of CMVI was discovered only in 1956 and is considered insufficiently studied. For a long time, the characteristic symptoms that develop during infection were called "kissing disease", since the most common way of transmission of infection is close contacts.

The only source of infection is a sick person or a virus carrier. CMV is determined in the main biological fluids of the body (saliva, urine, semen, cervical mucus, breast milk). A powerful release of the pathogen occurs both during the initial infection and at the time of each relapse, even if it is almost asymptomatic. Newborns with cytomegaly, as well as infected individuals with immunosuppression, pose a constant epidemiological danger.

Transmission routes include:

• contact - with prolonged and close household contacts;
• airborne - by inhalation of particles of the virus released during sneezing and coughing;
• sexual - with unprotected sexual intercourse;
• hematotransfusion - when transfusing infected blood;
• vertical - from mother to child in the womb or during childbirth.

Susceptibility to the virus is universal, that is, anyone can get infected. Women are just as susceptible to CMV infection as men.

Causes and pathogenesis

The only causative agent of the considered viral infection is CMV (CMV, Cytomegalovirus). So what is cytomegalovirus? Under this name, several types of viruses from the herpesvirus family are combined. One of them, type 5, is able to infect humans and cause cytomegalovirus infection in them.

The structure of CMV is simple: a viral particle consists of a virion with a diameter of nm and a closed capsid.

Like other members of the family, cytomegalovirus can stay in the body for a long time (usually in the salivary glands), without showing itself in any way. After the initial infection, it remains with the person for life. However, the infectiousness of the virus is low: in order to "catch" it, a long and fairly close contact with the source of infection is required.

Nevertheless, the prevalence of infection remains one of the highest in the world: antibodies to it are detected in 10-15% of adolescents and already 40-45% of people over 30 years old.

The main pathogenetic mechanism in the development of CMVI is considered to be damage by the virus to the cytoskeleton of cells and their significant increase in size. In addition, in a study conducted in 2009, a link was established between the persistence of the pathogen in the body and an increased risk of developing atherosclerosis. Therefore, the symptoms of cytomegalovirus infection are often accompanied by signs of circulatory disorders.

Clinical manifestations

And how does cytomegalovirus manifest itself in women? And is it possible to suspect the development of the disease in the early stages? For most people, the primary infection process goes unnoticed. Immediately after infection, an asymptomatic incubation period begins, which lasts an average of 20 to 60 days.

The acute phase of the disease either has no clinical symptoms at all, or passes as a respiratory infection. In this case, patients complain about:

• increase in temperature indicators;
• chills;
• fatigue, severe weakness;
• cranialgia and myalgia;
• catarrh of the nose and throat;
• discomfort, pain when swallowing;
• cough, chest pain.

Some patients also talk about an increase in peripheral lymph nodes, heaviness in the right hypochondrium.

After the initial development of cytomegalovirus infection in women, the pathogen settles in the body forever. Signs of exacerbation appear only with a decrease in protective forces, for example, with prolonged treatment with antibiotics, concomitant diseases and infections.

Among all the owners of cytomegalovirus, there are categories of patients for whom the infection is of particular danger. Among them: pregnant women, newborns, people with severe immunodeficiency (recipients of donor organs after transplantation, patients with oncohematological diseases, aplastic anemia, HIV-positive patients with a critical level of T-lymphocytes).

Cytomegalovirus during pregnancy

Symptoms and treatment of cytomegalovirus infection during pregnancy are of particular interest to specialists. The urgency of this problem, first of all, lies in the possibility of intrauterine infection of the fetus and the development of serious pathologies in it. That is why cytomegaly, along with herpes, rubella and toxoplasmosis, belongs to the so-called TORCH infections, which are preferably examined for before pregnancy.

Why is cytomegalovirus dangerous for the expectant mother and fetus? With the primary infection of a woman during pregnancy, intrauterine infection of the child occurs in 40-45% of cases.

Often the very fact of infection with cytomegalovirus goes unnoticed. Rarely, pregnant women experience a short flu-like syndrome that resolves on its own after 4-5 days.

Important! If a woman is infected with CMV before conception, the risk of developing a complication in a baby is minimal, no more than 1-2%.

However, later on, a cytomegalovirus infection can be recognized based on the following signs:

• the threat of termination of pregnancy;
• uterine hypertonicity;
• chorioamnionitis;
• premature aging of the placenta;
• oligohydramnios;
• large fruit.

CMVI fetus and newborn

From a pregnant woman to a child, the virus can be transmitted through: blood (CMV passes through the hematoplacental barrier), cervical canal (through membranes and complex fluid).

Thus, the fetus can become infected both at the intrauterine stage of development and during childbirth. Depending on when the infection occurred, the negative impact of the virus can be different:

• the first weeks (1-3) of pregnancy - the fertilized egg dies, menstruation comes;
• 3-10 weeks - the death of the embryo and spontaneous abortion, miscarriage, severe malformations;
• 11-28 weeks - intrauterine growth retardation, anomalies in the formation of internal organs, hydrocephalus, kidney pathology;
• 28-40 weeks - infection of the fetus without malformations: viral meningoencephalitis, myocarditis, hepatitis, pneumonitis.

In 20% of children born with manifestations of CMVI, a complex of signs of congenital cytomegaly is observed. And what is it?

Congenital cytomegaly is a severe complication of CMVI in newborns, manifested by:

• intense icteric coloration of the skin and mucous membranes (may last up to 5-6 months);
• hepatosplenomegaly - enlargement of the liver and spleen;
• profuse rash all over the body;
• tremors of the limbs;
• convulsive activity;
• drowsiness;
• visual and hearing impairments of varying severity.

In 20-30% of cases, newborns with cytomegaly die before they have lived even six months.

A woman who has given birth to a child with congenital cytomegaly is strictly forbidden to become pregnant for at least 2 years.

Cytomegalovirus infection in women with immunodeficiency

Much more vivid symptoms of CMVI in women with various immunodeficiency states. Along with signs of acute respiratory infections and influenza-like syndrome, primary infection can be manifested by lesions of the genitourinary system: cervicitis, cervical erosion, endometritis, vaginitis, oophoritis.

It is this atypical course of the disease that most often poses a threat to the fetus developing in the womb.

In the future, manifestations of infection in patients with reduced body defenses are characterized by the frequent development of complications:

• viral pneumonia - an inflammatory lesion of the pulmonary acini;
• pleurisy - inflammation of the visceral membrane of the lungs with sweating of a large amount of exudate;
• myocarditis and heart failure;
• arthritis
• encephalitis.

Less common are generalized forms of CMVI. Their symptoms are:

• multiple pathological processes in the internal organs (liver, spleen, adrenal glands, kidneys, pancreas, etc.);
• indigestion;
• damage to the central nervous system, the appearance of inflammatory foci in the deep subcortical structures of the brain;
• rarely - spreading paresis, paralysis.

In most cases, such serious lesions are fatal. Therefore, the search for relevant approaches to the treatment and prevention of CMVI in patients with congenital and acquired forms of immunodeficiency is one of the priorities of healthcare.

Diagnostic approaches

The main diagnostic method for detecting cytomegalovirus infection in women is enzyme immunoassay. It is based on the determination of specific antibodies of the pathogen in a blood sample using various biochemical reactions.

The test detects two types of antibodies - Ig G and Ig M. The first is formed after past infections and allows the body to quickly recognize the pathogen in case of re-infection. The second is produced in response to the first introduction of the virus or during relapses of a chronic infection and helps in the fight against it “here and now”.

Depending on the results of the tests, it is possible to say with certainty whether a woman is infected with CMVI, and also to give the patient recommendations for planning a pregnancy.

In addition, the diagnosis of CMVI is made on the basis of:

• PCR studies of biological fluids (blood, saliva, urine, etc.);
• inoculation of biomaterial in cell culture.

These tests not only detect the virus, but also provide information about the degree of its activity and aggressiveness. Against the background of ongoing therapy, they allow us to judge its effectiveness.

Is it possible to cure CMVI forever?

How to treat cytomegalovirus? Unfortunately, with medications available to modern medicine, it is impossible to rid the body of the CMVI pathogen forever. Instead, the goals of therapy include:

• strengthening immunity;
• transfer of infection from active to latent form;
• cessation of virus excretion by the patient;
• elimination of the symptoms of the disease.

Treatment of cytomegalovirus in women requires an individual approach. Thus, asymptomatic virus carrying in patients with normal immunity does not require any therapeutic measures. With influenza-like or mononucleosis-like syndromes, the attending physician may prescribe standard detoxification measures (plenty of warm drink, bed rest, light food) and symptomatic drugs (antipyretic, anti-inflammatory, expectorant, etc.).

In case of activation of the virus against the background of a weakened immune system, self-medication is strictly prohibited. You should contact an infectious disease specialist who will prescribe therapy based on the characteristics of the patient's body and the initial level of antibodies.

An effective drug for the complete eradication of the pathogen from the body has not yet been developed. Most antiviral agents used to treat other infections are completely powerless against CMV. However, developments continue, and the use of glycyrrhizic acid obtained from licorice rhizomes is considered promising in modern medicine.

And how to treat complicated CMVI? Complex inpatient treatment is indicated for the diagnosis of severe generalized forms of cytomegalovirus infection. Apply:

• antiviral drugs - Ganciclovir, Foxarnet, Valganciclovir;
• anticytomegalovirus immunoglobulins - Cytotect;
• immunomodulators;
• symptomatic and detoxifying agents.

Since antiviral agents known to medicine have many side effects and are toxic to the body, infectious disease specialists use them only for health reasons.

Prevention

Measures of specific prevention of CMVI have not been developed. For relatively healthy individuals with normal immunity, this infection does not pose a danger.

It is advisable for women planning pregnancy to visit a doctor and get tested for TORCH infections. If Ig G and Ig M to cytomegalovirus are negative, then the patient's body has not yet encountered the pathogen, and it is important to prevent infection during the gestation of the baby.

Measures to prevent CMVI include:

• limiting contact with possible sources of the virus: preschoolers, people with confirmed antibodies to the virus, sneezing and coughing people in public places;
• refusal from close household contacts, kisses with infected persons;
• refusal to use other people's household items, utensils;
• fidelity to a permanent sexual partner;
• use of condoms during sexual intercourse;
• strengthening immunity:
  • daily walks in the air;
  • physical education;
  • full sleep;
  • nutrition rich in vitamins and nutrients;
  • timely treatment of acute infections and chronic diseases;
  • positive inner attitude.

Note! Products such as whole milk and dairy products, pears and apples are considered indispensable in the prevention of all types of herpes infection.

Cytomegalovirus is an asymptomatic and, in general, non-dangerous pathology, which for some categories of the population can pose a serious threat to health and life. Careful planning of pregnancy, timely treatment of immunodeficiency conditions and adherence to the principles of a healthy lifestyle are the main methods for preventing exacerbations and relapses of infection. It is they who will allow a woman to forget about the manifestations of CMVI, as well as to endure and give birth to healthy children.

is a latent virus that is in the human body. Its main feature is that most people are unaware of the presence of infection.

According to medical examinations, 15-20% of adolescents and 60% of the population over 40 years of age are carriers of type 5 herpes.

Infection is dangerous because medicine at the present stage of development is not able to prevent infection and help sick people.

Cytomegalovirus (CMV) is a virus from the herpevirus family that can cause cytomegalovirus in humans.

If the immune system of a man is weakened (against the background of acute respiratory viral infections or pneumonia, the presence of cancer, etc.), then a violation of the internal organs is possible:

1. Diseases of the genitourinary system, accompanied by pain during urination.
2. Pneumonia, myocarditis, encephalitis (in a critical case).
3. Paralysis and death (in very rare cases).

It should be aimed at eliminating the inflammatory process and keeping the virus in an inactive form.

What is the risk for women?

Cytomegalovirus for girls, as well as for men, is dangerous in case of reduced immunity. Infection can provoke the occurrence of various diseases:

• inflammation of the female genital organs;
• pleurisy, pneumonia;
• intestinal inflammation;
• neurological diseases (in extreme cases - encephalitis).

The most dangerous. Especially if the infection occurred in the first trimester of pregnancy. The virus can infect the fetus, and this will lead to the death of the embryo. At a later stage of pregnancy, the infection can have a negative impact on the formation of the internal organs of the baby. Therefore, it is important to check for infections when planning a pregnancy. In the presence of cytomegalovirus and antibodies to it in the body of a girl before pregnancy, a favorable outcome is most likely (the child will be a passive carrier of CMV).

For children

Many parents are wondering if it is dangerous? It depends on the type of infection and the age of the baby. The most dangerous consequences are revealed in the congenital form of the disease in a child under 1 year old:

• disruption of the liver and spleen;
• bronchitis, pneumonia;
• jaundice.

If the baby acquired the virus during the first year of life, then the disease is milder. Symptoms are similar to SARS:

• runny nose;
• heat;
• swollen lymph nodes;
• increased fatigue.

Older age the disease is most often asymptomatic. Sometimes drowsiness and fever may occur. The disease in the acquired form rarely gives a complication to the health of the child.

Features of development and effect on the body

Cytomegalovirus is a fairly large virus (150-190 nm). Thanks to this, CMV got its name, literal translation, "giant cell". The virus enters a healthy cell and increases many times its size. The content of the cell is significantly reduced (sticks together), and the entire space is filled with liquid. Infected cells become large, stop dividing and die. In this case, inflammation of the surrounding tissues occurs.

Depending on the way CMV enters the human body, the degree of influence on internal systems depends:

• if the virus has penetrated through saliva, then the nasopharynx and bronchi suffer;
• with a lesion through the genital organs, the infection penetrates into the bladder, kidneys, uterus;
• in the blood, CMV damages leukocytes, lymphocytes, and then the centers of the spinal cord and brain.

However, a strong immune system quickly detects the virus and begins to fight it, forming antibodies. After that, the virus goes into a dormant form and remains in the human body forever.

Why carriers are dangerous

The source of infection of cytomegalovirus can be a patient with an active stage of the disease, and a person without any signs of infection. In a healthy body, antibodies begin to be produced after infection. This stage is called the latent period of the disease and lasts 4-8 weeks.

The most dangerous carrier of the virus is during the time that begins after the latent stage and lasts from 15 to 60 days. During this period, the patient develops symptoms of the disease similar to SARS:

• chills;
• high body temperature;
• headache;
• runny nose;
• skin rash;
• malaise and fatigue.

At this stage, CMV multiplies very actively and the patient is dangerous to others. You can become infected through saliva and other secretions. However, this danger of infection extends to specific populations. First of all, the risk group includes people with reduced immunity:

• girls and their baby during pregnancy;
• preschool children;
• patients with oncology after courses of chemotherapy;
• people with HIV infection;
• patients after transplantation of donor organs.

For the rest of the population, carriers of cytomegalovirus do not pose a big threat.

Consequences of the virus after recovery

With timely treatment of CMV, significant consequences in the state of human health are not observed. In the acute form of herpes, it is standard for the patient to prescribe and. If cytomegaly is asymptomatic, then there is no need for treatment.

Summing up, we can say that cytomegalovirus is dangerous for people with weakened immune systems. Because there are no medicines to fight the disease yet. But a person can always improve his health: go in for sports, harden,. A strong immune system is the best cure for infections.

Cytomegaly

General information

Cytomegaly- an infectious disease of viral origin, transmitted sexually, transplacental, household, blood transfusion. Symptomatically proceeds in the form of persistent cold. There is weakness, malaise, headaches and joint pain, runny nose, enlargement and inflammation of the salivary glands, profuse salivation. Often asymptomatic. The severity of the course of the disease is due to the general state of immunity. In the generalized form, severe foci of inflammation occur throughout the body. Pregnant cytomegaly is dangerous: it can cause spontaneous miscarriage, congenital malformations, intrauterine fetal death, congenital cytomegaly.

Other names for cytomegaly found in medical sources are cytomegalovirus infection (CMV), inclusion cytomegaly, viral disease of the salivary glands, inclusion disease. The causative agent of cytomegalovirus infection, cytomegalovirus, belongs to the human herpesvirus family. Cells affected by cytomegalovirus multiply in size, so the name of the disease "cytomegaly" is translated as "giant cells".

Cytomegaly is a widespread infection, and many people who are carriers of cytomegalovirus are not even aware of it. The presence of antibodies to cytomegalovirus is detected in 10-15% of the population in adolescence and in 50% of adults. According to some sources, the carriage of cytomegalovirus is determined in 80% of women of the childbearing period. First of all, this refers to the asymptomatic and oligosymptomatic course of cytomegalovirus infection.

Not all people who carry cytomegalovirus are sick. Often, cytomegalovirus is in the body for many years and may never manifest itself and not harm a person. The manifestation of a latent infection occurs, as a rule, when the immune system is weakened. Threatening in its consequences, the danger of cytomegalovirus is in people with reduced immunity (HIV-infected, who have undergone bone marrow transplantation or internal organs taking immunosuppressants), with a congenital form of cytomegalovirus, in pregnant women.

Ways of transmission of cytomegalovirus

Cytomegaly is not a highly contagious infection. Usually, infection occurs through close, prolonged contact with carriers of cytomegalovirus. Cytomegalovirus is transmitted in the following ways:

• airborne: when sneezing, coughing, talking, kissing, etc.;
• sexually: during sexual contact through semen, vaginal and cervical mucus;
• blood transfusion: with blood transfusion, leukocyte mass, sometimes - with transplantation of organs and tissues;
• transplacental: during pregnancy from mother to fetus.

The mechanism of development of cytomegaly

Once in the blood, cytomegalovirus causes a pronounced immune reaction, manifested in the production of protective protein antibodies - immunoglobulins M and G (IgM and IgG) and an antiviral cellular reaction - the formation of CD 4 and CD 8 lymphocytes. Inhibition of cellular immunity in HIV infection leads to active development cytomegalovirus and the infection it causes.

The formation of immunoglobulins M, indicating a primary infection, occurs 1-2 months after infection with cytomegalovirus. After 4-5 months, IgM are replaced by IgG, which are found in the blood throughout the rest of life. With strong immunity, cytomegalovirus does not cause clinical manifestations, the course of infection is asymptomatic, hidden, although the presence of the virus is determined in many tissues and organs. By infecting cells, cytomegalovirus causes an increase in their size; under a microscope, the affected cells look like an “owl's eye”. Cytomegalovirus is determined in the body for life.

Even with an asymptomatic course of infection, the carrier of cytomegalovirus is potentially contagious to uninfected individuals. An exception is the intrauterine route of transmission of cytomegalovirus from a pregnant woman to the fetus, which occurs mainly during the active course of the process, and only in 5% of cases causes congenital cytomegaly, while in the rest it is asymptomatic.

Forms of cytomegaly

congenital cytomegaly

In 95% of cases, intrauterine infection of the fetus with cytomegalovirus does not cause the development of the disease, but is asymptomatic. Congenital cytomegalovirus infection develops in newborns whose mothers have had primary cytomegalovirus. Congenital cytomegaly can manifest itself in newborns in various forms:

• petechial rash - small skin hemorrhages - occurs in 60-80% of newborns;
• prematurity and intrauterine growth retardation - occurs in 30% of newborns;
• chorioretinitis is an acute inflammatory process in the retina of the eye, often causing a decrease and complete loss of vision.

Mortality in intrauterine infection with cytomegalovirus reaches 20-30%. Of the surviving children, most have a mental retardation or a hearing and vision disability.

Acquired cytomegaly in newborns

When infected with cytomegalovirus during childbirth (during the passage of the fetus through the birth canal) or in the postpartum period (during household contact with an infected mother or breastfeeding), in most cases an asymptomatic course of cytomegalovirus infection develops. However, in preterm infants, cytomegalovirus can cause prolonged pneumonia, which is often accompanied by a concomitant bacterial infection. Often, when children are affected by cytomegalovirus, there is a slowdown in physical development, an increase in lymph nodes, hepatitis, and a rash.

Mononucleosis-like syndrome

In individuals who have left the neonatal period and have normal immunity, cytomegalovirus can cause the development of a mononucleosis-like syndrome. The clinical course of a mononuclease-like syndrome does not differ from infectious mononucleosiscaused by another type of herpes virus - the Ebstein-Barr virus. The course of a mononucleosis-like syndrome resembles a persistent cold infection. It notes:

• prolonged (up to 1 month or more) fever with high body temperature and chills;
• aching joints and muscles, headache;
• pronounced weakness, malaise, fatigue;
• sore throat;
• enlarged lymph nodes and salivary glands;
• skin rashes resembling rubella rash (usually occurs during treatment with ampicillin).

In some cases, a mononucleosis-like syndrome is accompanied by the development of hepatitis - jaundice and an increase in liver enzymes in the blood. Even less often (up to 6% of cases), pneumonia is a complication of mononucleosis-like syndrome. However, in individuals with normal immune reactivity, it proceeds without clinical manifestations, being detected only when X-rays of the lungs are performed.

The duration of the mononucleosis-like syndrome is from 9 to 60 days. Then, a complete recovery usually occurs, although residual effects in the form of malaise, weakness, and enlarged lymph nodes may persist for several months. Rarely, cytomegalovirus activation causes recurrences of the infection with fever, sweating, hot flashes, and malaise.

Cytomegalovirus infection in immunocompromised individuals

Weakened immunity is observed in persons suffering from congenital and acquired immunodeficiency syndrome (AIDS), as well as in patients who have undergone transplantation of internal organs and tissues: heart, lung, kidney, liver, bone marrow. After organ transplantation, patients are forced to constantly take immunosuppressants, leading to a pronounced suppression of immune responses, which causes the activity of cytomegalovirus in the body.

In patients who have undergone organ transplantation, cytomegalovirus causes damage to donor tissues and organs (hepatitis in liver transplants, pneumonia in lung transplants, etc.). After bone marrow transplantation, in 15-20% of patients, cytomegalovirus can lead to the development of pneumonia with high mortality (84-88%). The greatest danger is the situation when a cytomegalovirus-infected donor material is transplanted to an uninfected recipient.

Cytomegalovirus infects almost all HIV-infected people. At the onset of the disease, malaise, joint and muscle pain, fever, night sweats are noted. In the future, these signs may be accompanied by cytomegalovirus lesions of the lungs (pneumonia), liver (hepatitis), brain (encephalitis), retina (retinitis), ulcerative lesions and gastrointestinal bleeding.

In men, cytomegalovirus can affect the testicles, prostate, in women - the cervix, the inner layer of the uterus, vagina, ovaries. Complications of cytomegalovirus infection in HIV-infected people can be internal bleeding from the affected organs, loss of vision. Multiple damage to organs by cytomegalovirus can lead to their dysfunction and death of the patient.

Diagnosis of cytomegaly

In order to diagnose cytomegalovirus infection, a laboratory determination of specific antibodies to cytomegalovirus, immunoglobulins M and G, is carried out in the blood. The presence of immunoglobulins M may indicate a primary infection with cytomegalovirus or a reactivation of a chronic cytomegalovirus infection. Determination of high titers of IgM in pregnant women may threaten infection of the fetus. An increase in IgM is detected in the blood 4-7 weeks after infection with cytomegalovirus and is observed for 16-20 weeks. An increase in immunoglobulins G develops during the period of attenuation of the activity of cytomegalovirus infection. Their presence in the blood indicates the presence of cytomegalovirus in the body, but does not reflect the activity of the infectious process.

To determine the DNA of cytomegalovirus in blood cells and mucous membranes (in scrapings from the urethra and cervical canal, in sputum, saliva, etc.), the PCR diagnostic method (polymerase chain reaction) is used. Especially informative is the quantitative PCR, which gives an idea of ​​the activity of cytomegalovirus and the infectious process it causes. The diagnosis of cytomegalovirus infection is based on the isolation of cytomegalovirus in clinical material or with a fourfold increase in antibody titer. Treatment of cytomegalovirus infection in individuals at risk is carried out with the antiviral drug ganciclovir. In cases of severe cytomegalovirus, ganciclovir is administered intravenously, since the tablet forms of the drug have only a preventive effect against cytomegalovirus. Since ganciclovir has severe side effects (causes hematopoiesis suppression - anemia, neutropenia, thrombocytopenia, skin reactions, gastrointestinal disorders, fever and chills, etc.), its use is limited in pregnant women, children and people suffering from renal insufficiency (only for health reasons), it is not used in patients without impaired immunity.

For the treatment of cytomegalovirus in HIV-infected people, the most effective drug is foscarnet, which also has a number of side effects. Foscarnet can cause electrolyte disturbances (a decrease in magnesium and potassium in the blood plasma), ulceration of the genital organs, impaired urination, nausea, and kidney damage. These adverse reactions require careful use and timely adjustment of the dose of the drug.

Prevention

The issue of prevention of cytomegalovirus infection is especially acute in individuals at risk. The most susceptible to infection with cytomegalovirus and the development of the disease are HIV-infected (especially AIDS patients), patients after organ transplantation and persons with immunodeficiency of a different origin.

Non-specific methods of prevention (for example, personal hygiene) are ineffective against cytomegalovirus, since infection with it is possible even by airborne droplets. Specific prophylaxis of cytomegalovirus infection is carried out with ganciclovir, acyclovir, foscarnet among patients at risk. Also, to exclude the possibility of infection of recipients with cytomegalovirus during organ and tissue transplantation, it is necessary to carefully select donors and control donor material for the presence of cytomegalovirus infection.

Cytomegalovirus is of particular danger during pregnancy, as it can provoke a miscarriage, stillbirth, or cause severe congenital deformities in a child. Therefore, cytomegalovirus, along with herpes, toxoplasmosis and rubella, is one of those infections that women should be examined for prophylactically, even at the stage of pregnancy planning.

Asking the question of why cytomegalovirus is dangerous, first you need to find out what this disease is and what complications it can incur. Cytomegaly is a viral disease that affects the salivary glands. Often this pathology is referred to as the so-called diseases of civilization. This is due to the widespread prevalence of the virus.

Features of the disease

A cytomegalovirus infection was discovered recently - in the 20th century. The peculiarity of this disease lies in the dangerous toxic effect on the cells of the human body.

By name, you can determine the characteristic properties of the pathology. Translated from the Greek language "cytos" is a cell. The word "mega" is translated as "big". The main concept is "virus" - poison.

CMV is a representative of the herpes virus of the fifth type. To date, official medicine knows 3 strains of this disease.

Another characteristic feature is that CMV can be in the human body for a long period. The development of the disease is asymptomatic, which makes it difficult to determine its presence. But the carrier is contagious to all partners.

The virus has a direct exit to the salivary glands, so the initial stages of diagnosis begin with this part. The development of the disease occurs in human fibroblast cells.

When exposed to a pathogen, cells in the connective tissue begin to gradually increase and, as a result, reach enormous sizes. As viral elements accumulate, progeny virions are formed.

When the disease is neglected, cell rupture is observed. The affected particles enter the bloodstream and begin to attack healthy cells. Therein lies the danger. With untimely treatment, the human body is completely weakened.

Transmission routes

Cytomegalovirus is one of the most common diseases that affects people around the world. There are several ways of infection, and the first is the contact-household type of transmission. This option is the most difficult. For infection to occur, people must be in close and prolonged contact. Most often, this type is common in family communication.

Another way of transmission is sexual. Most often, infection occurs through unprotected contact with the carrier. The danger lies in biological fluids.

Can occur from woman to child. This species is called the vertical route of infection, and its features include the following:

• infection occurs during pregnancy;
• infection is possible only if the expectant mother acquires this disease for the first time;
• the virus is transmitted through milk.

The last type is the iatrogenic route of infection. Transmission of the virus occurs during medical procedures. Most often, the disease is transmitted during a blood transfusion or organ transplant.

Manifestation of symptoms

The development of pathology occurs asymptomatically. The duration of the incubation period is 50-60 days. In the presence of a pathogen, a person does not encounter obvious manifestations. Rarely, clinical symptoms occur, but there are no more pronounced signs.

Sometimes there are such manifestations:

The peculiarity of this virus is that it masquerades as SARS. A person's health worsens, rapid fatigue is observed.

A characteristic symptom of the disease is the compaction of the lymph nodes. The parotid salivary gland also increases in size.

Complications of the disease

With untimely treatment, the negative consequences of cytomegalovirus can have a strong impact on the human body. This virus belongs to TORCH infections that cause birth defects in a child. With development, the fetus faces a negative influence during the first trimester.

Infection can occur both during pregnancy and during childbirth. Most often, the consequences of cytomegalovirus infection are congenital hepatitis, jaundice, and a minimal platelet count.

These complications can have serious consequences later in life. Cytomegalovirus is dangerous because in its presence inflammation of the brain often develops.

One of the most specific features is the deposition of calcium in the subcortical medulla.

How to cure a disease

If there are characteristic signs, you should immediately contact a specialist. Basically, the diagnosis and treatment of the disease is not possible without special laboratory tests. This is due to the absence of clinical signs.

One of the most effective and used diagnostic methods is the detection of antibodies to the antigen of the disease. These methods include ELISA and NIFR. The second option is used to identify the proteins of the pathogen to the patient's leukocytes.

First of all, each patient should understand that a doctor treats cytomegalovirus, and it is strictly forbidden to deal with the elimination of the disease on your own. To combat pathology, donor immunoglobulin is used. With the introduction of this substance, the manifestation of the clinical picture decreases.

During pregnancy, it is necessary to undergo regular examination by the attending gynecologist. There are those who are able to eliminate symptomatic manifestations in this period. Newborns should only be treated by a pediatrician who will prescribe drug therapy.

Ganciclovir treatment is used for patients suffering from secondary immunodeficiency. The therapy is suitable for people with severe systemic diseases and malignant tumors.

Cytomegalovirus: complications - what can they be? First, it should be noted that complications usually appear in those people who have noticeably weakened immunity.

Cytomegalovirus: what consequences after it are possible with weak body defenses? As a rule, this is a disturbed functioning of the gastrointestinal tract (inflammation of the large intestine, diarrhea or constipation, bloating, the appearance of blood in the feces), hepatitis, an increase in body temperature for no clear reason, and improper functioning of internal organs.

What else can happen to the human body as a result of complications?

1. The lung tissue can become inflamed, which is called pneumonia. This is the most common complication of the human respiratory system;
2. If the nasal mucosa is affected and damaged, a person will develop a chronic runny nose;
3. From the side of the nervous system, complications such as brain inflammation (encephalitis) can occur;
4. Women may experience inflammation of the uterus called endometritis, as well as inflammation of the cervix (cervicitis). In addition, they may develop inflammation of the vagina (vaginitis) and other gynecological problems;
5. In general, it is very difficult for people to fight such a disease and sooner or later a fatal outcome occurs (). This is especially true for HIV-infected people.

Cytomegalovirus: consequences for the fetus

1. Defect of the cardiac septum;
2. Microcephaly. Such a pathology is an insufficient mass of the brain and a small size of the cranium;
3. Narrowing of the pulmonary trunk;
4. Abnormal structure of the lungs and kidneys;
5. Developmental disorders of the brain.

If there was an infection of the fetus at a late stage of pregnancy, what will happen? Cytomegalovirus in a newborn: consequences usually include:

1. The occurrence of jaundice;
2. Autism;
3. Problems with coordination of movements;
4. Seizures that can lead to the death of the baby;
5. Serious visual impairment;
6. Mental changes.

The child had been ill with cytomegalovirus: consequences

Since it is not possible to completely cure such a disease, it will periodically make itself felt during the life of a child.

It is also worth remembering that in some cases even timely treatment cannot save the child from the development of complications, since sometimes the cytomegalovirus proceeds unpredictably.

The most common complications in children are:

1. Disturbed work of the nervous system;
2. cytomegalovirus pneumonia;
3. Inflammation of the brain, which is also called encephaly;
4. Eye diseases that can cause strabismus and blindness.

Thus, quite a few complications can occur. Although a doctor may not always be able to provide a valid treatment, it is still best to consult a specialist if you have suspicions. This is especially true for mothers of infected children. There is hope that treatment will help.