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Cytomegalovirus (CMV) infection
CMV mononucleosis; Cytomegalovirus; CMV; Human cytomegalovirus; HCMV
Cytomegalovirus (CMV) infection is a disease caused by a type of herpes virus.
Causes
Infection with CMV is very common. The infection is spread by:
- Blood transfusions
- Organ transplants
- Respiratory droplets
- Saliva
- Sexual contact
- Urine
- Tears
Most people come into contact with CMV in their lifetime. But usually, it's people with a weakened immune system, such as those with HIV/AIDS, who become ill from CMV infection. Some otherwise healthy people with CMV infection develop a mononucleosis-like syndrome.
CMV is a type of herpes virus. All herpes viruses remain in your body for the rest of your life. If your immune system becomes weakened in the future, this virus may have the chance to reactivate, causing symptoms.
Symptoms
Many people are exposed to CMV early in life, but do not realize it because they have no symptoms, or they have mild symptoms that resemble the common cold. These may include:
- Enlarged lymph nodes, especially in the neck
-
Fever
Fever
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...
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Fatigue
Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
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Loss of appetite
Loss of appetite
A decreased appetite is when your desire to eat is reduced. The medical term for a loss of appetite is anorexia.
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Malaise
Malaise
Malaise is a general feeling of discomfort, illness, or lack of well-being.
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Muscle aches
Muscle aches
Muscle aches and pains are common and can involve more than 1 muscle. Muscle pain also can involve ligaments, tendons, and fascia. Fascia are the s...
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- Sore throat
Depending on which part of the body is affected by CMV, symptoms may include:
-
Chest pain
Chest pain
Chest pain is discomfort or pain that you feel anywhere along the front of your body between your neck and upper abdomen.
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Cough
Cough
Coughing is an important way to keep your throat and airways clear. But too much coughing may mean you have a disease or disorder. Some coughs are d...
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-
Hives
Hives
Hives are raised, often itchy, red bumps (welts) on the surface of the skin. They are usually an allergic reaction to food or medicine. They can al...
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- Jaundice
- Neck stiffness
-
Rapid heart rate
Rapid heart rate
A bounding pulse is a strong throbbing felt over one of the arteries in the body. It is due to a forceful heartbeat.
ImageRead Article Now Book Mark Article - Sensitivity to light
-
Shortness of breath
Shortness of breath
Breathing difficulty may involve:Difficult breathingUncomfortable breathingFeeling like you are not getting enough air
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Exams and Tests
Your health care provider will perform a physical exam and feel your belly area. Your liver and spleen may be tender when they are gently pressed (palpated). You may have a skin rash.
Special lab tests such as a CMV DNA serum PCR test may be done to check for presence of substances in your blood produced by CMV. Tests, such as a CMV antibody test, may be done to check the body's immune response to the CMV infection.
CMV DNA serum PCR test
The CMV serology test determines the presence of antibodies to a virus called cytomegalovirus (CMV) in the blood.
Other tests may include:
-
Blood tests for
platelets
and white blood cells
Platelets
A platelet count is a lab test to measure how many platelets you have in your blood. Platelets are parts of the blood that help the blood clot. The...
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Chemistry panel
Chemistry panel
A comprehensive metabolic panel is a group of blood tests. They provide an overall picture of your body's chemical balance and metabolism. Metaboli...
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Liver function tests
Liver function tests
Liver function tests are common tests that are used to see how well the liver is working. Tests include:AlbuminAlpha-1 antitrypsin Alkaline phosph...
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Mono spot test
(to distinguish from mono infection)
Mono spot test
The mononucleosis spot test looks for 2 antibodies in the blood. These antibodies appear during or after an infection with the virus that causes mon...
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Treatment
Most people recover in 4 to 6 weeks without medicine. Rest is needed, sometimes for a month or longer to regain full activity levels. Painkillers and warm salt-water gargles can help relieve symptoms.
Antiviral medicines are usually not used in people with healthy immune function.
Outlook (Prognosis)
Outcome is good with treatment. The symptoms may be relieved in a few weeks to months.
Possible Complications
Throat infection is the most common complication. Rare complications include:
-
Colitis
Colitis
Colitis is swelling (inflammation) of the large intestine (colon).
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Guillain-Barre syndrome
Guillain-Barre syndrome
Guillain-Barré syndrome is a serious health problem that occurs when the body's defense (immune) system mistakenly attacks part of the nervous system...
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-
Pericarditis
or
myocarditis
Pericarditis
Pericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.
ImageRead Article Now Book Mark ArticleMyocarditis
Myocarditis is inflammation of the heart muscle. The condition is called pediatric myocarditis when it occurs in children.
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Pneumonia
Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
ImageRead Article Now Book Mark Article - Rupture of the spleen
- Inflammation of liver (hepatitis)
When to Contact a Medical Professional
Call for an appointment with your provider if you have symptoms of CMV infection.
Go to the emergency room or call the local emergency number (such as 911) if you have sharp, severe sudden pain in your left upper abdomen. This could be a sign of a ruptured spleen, which may require emergency surgery.
Prevention
CMV infection can be contagious if the infected person comes in close or intimate contact with another person. You should avoid kissing and sexual contact with an infected person.
The virus may also spread among young children in day care settings.
When planning blood transfusions or organ transplants, the CMV status of the donor can be checked to avoid passing CMV to a recipient who has not had CMV infection.
References
Crumpacker CS. Cytomegalovirus (CMV). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases, Updated Edition . 8th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 140.
Drew WL. Cytomegalovirus. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine . 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 376.
-
Mononucleosis, photomicrograph of cells - illustration
This so-called "Downy cell" is typical of lymphocytes infected by EBV (Epstein Barr Virus) or CMV (Cytomegalovirus) in infectious mononucleosis. Downy cells may be classified as types I, II, or III. This is a type II Downy cell.
Mononucleosis, photomicrograph of cells
illustration
-
Mononucleosis, photomicrograph of cells - illustration
This is a lymphocyte that has been infected by the Epstein-Barr Virus (EBV) or Cytomegalovirus (CMV) in infectious mononucleosis and is referred to as a "Downy cell". Downy cells may be classified as types I, II, or III; this is a type I Downy cell.
Mononucleosis, photomicrograph of cells
illustration
-
Infectious mononucleosis #3 - illustration
Infectious mononucleosis is caused by the Epstein-Barr virus. It is a viral infection causing high temperature, sore throat, and swollen lymph glands. Infectious mononucleosis can be contagious if the infected person comes in close or intimate contact with another person through saliva or sexual contact.
Infectious mononucleosis #3
illustration
-
Infectious mononucleosis - illustration
Swollen lymph nodes, sore throat, fatigue and headache are some of the symptoms of mononucleosis, which is caused by the Epstein-Barr virus. It is generally self-limiting and most patients can recover in 4 to 6 weeks without medications.
Infectious mononucleosis
illustration
-
Mononucleosis, photomicrograph of cell - illustration
This picture shows large, atypical lymphocytes (white blood cells). These cells are seen in viral infections, most commonly caused by the Epstein-Barr virus (infectious mononucleosis), cytomegalovirus diseases, and occasionally infectious hepatitis. This is an example of a type I Downy cell.
Mononucleosis, photomicrograph of cell
illustration
-
Mononucleosis - mouth - illustration
Infectious mononucleosis is caused by the Epstein-Barr virus. In teenagers and young adults, there is frequently a sore throat and red tonsils with whitish spots (exudate), as seen in this picture. Enlarged lymph nodes and fatigue are also common.
Mononucleosis - mouth
illustration
-
Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
-
Mononucleosis, photomicrograph of cells - illustration
This so-called "Downy cell" is typical of lymphocytes infected by EBV (Epstein Barr Virus) or CMV (Cytomegalovirus) in infectious mononucleosis. Downy cells may be classified as types I, II, or III. This is a type II Downy cell.
Mononucleosis, photomicrograph of cells
illustration
-
Mononucleosis, photomicrograph of cells - illustration
This is a lymphocyte that has been infected by the Epstein-Barr Virus (EBV) or Cytomegalovirus (CMV) in infectious mononucleosis and is referred to as a "Downy cell". Downy cells may be classified as types I, II, or III; this is a type I Downy cell.
Mononucleosis, photomicrograph of cells
illustration
-
Infectious mononucleosis #3 - illustration
Infectious mononucleosis is caused by the Epstein-Barr virus. It is a viral infection causing high temperature, sore throat, and swollen lymph glands. Infectious mononucleosis can be contagious if the infected person comes in close or intimate contact with another person through saliva or sexual contact.
Infectious mononucleosis #3
illustration
-
Infectious mononucleosis - illustration
Swollen lymph nodes, sore throat, fatigue and headache are some of the symptoms of mononucleosis, which is caused by the Epstein-Barr virus. It is generally self-limiting and most patients can recover in 4 to 6 weeks without medications.
Infectious mononucleosis
illustration
-
Mononucleosis, photomicrograph of cell - illustration
This picture shows large, atypical lymphocytes (white blood cells). These cells are seen in viral infections, most commonly caused by the Epstein-Barr virus (infectious mononucleosis), cytomegalovirus diseases, and occasionally infectious hepatitis. This is an example of a type I Downy cell.
Mononucleosis, photomicrograph of cell
illustration
-
Mononucleosis - mouth - illustration
Infectious mononucleosis is caused by the Epstein-Barr virus. In teenagers and young adults, there is frequently a sore throat and red tonsils with whitish spots (exudate), as seen in this picture. Enlarged lymph nodes and fatigue are also common.
Mononucleosis - mouth
illustration
-
Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
Review Date: 7/31/2016
Reviewed By: Jatin M. Vyas, MD, PhD, Assistant Professor in Medicine, Harvard Medical School; Assistant in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
