12- Cytomegalovirus (CMV)
Transcript of 12- Cytomegalovirus (CMV)
-
8/12/2019 12- Cytomegalovirus (CMV)
1/17
DR.MOHAMMED ARIF
ASSOCIATE PROFESSOR
CONSULTANT VIROLOGIST
HEAD OF THE VIROLOGY UNIT
Cytomegalovirus (CMV)
-
8/12/2019 12- Cytomegalovirus (CMV)
2/17
Virology
Family: Herpesvirinae.
Subfamily: Betaherpesvirinae.
Enveloped, icosahedral particle, about 200nm. The viral genome is ds-DNA.
Replicate in the nucleus.
-
8/12/2019 12- Cytomegalovirus (CMV)
3/17
EM of herpes virus .
-
8/12/2019 12- Cytomegalovirus (CMV)
4/17
Disease associated with CMV
In immunocompetent host.
In immunocompromoized.
Congenital infection
-
8/12/2019 12- Cytomegalovirus (CMV)
5/17
1- infection in immunocompetent hosts
CMV is an opportunistic virus that rarely causes diseases inhealthy people, particularly when infection occurs in childhood.
About 70-90% of adults have antibody to CMV.
In adolescence and early adult hood primary CMV infectionis usually asymptomatic, but may cause infectiousmononucleosis like syndrome.
-
8/12/2019 12- Cytomegalovirus (CMV)
6/17
Infectious mononucleosis like syndrome
It is a disease of adolescent and young adults.
Symptoms include: fever, loss of appetite, malaise,
splenomegaly, impaired liver function,lymphocytosis with atypical lymphocytes, but
without characteristic pharyngitis andlymphadenopathy.
Patients are negative for heterophil antibody tosheep red blood cell (SRBC).
-
8/12/2019 12- Cytomegalovirus (CMV)
7/17
Infectious mononucleosis like syndrome
Mild hepatitis and pneumonia may observed in patientswith primary CMV-infection and infectious mononucleosislike syndrome.
Duration; 2-4 weeks.
prognosis: recovery is usual.
Treatment: Infectious mononucleosis like syndrome is afairly mild illness, requires no antiviral drug treatment.
-
8/12/2019 12- Cytomegalovirus (CMV)
8/17
Lab. diagnosis
By detection of Ig-M antibody to CMV.
-
8/12/2019 12- Cytomegalovirus (CMV)
9/17
2- Infection in the immunocompromized hosts.
CMV causes severe diseases in the immunocompromizedsuch as transplant patients , patients with AIDS andpatients receiving chemotherapy or other
immunosuppressive therapy.
CMV causes disease in almost every organ of the body, e.g.,pneumonia, hepatitis, colitis, retinitis, and neuropathy.
-
8/12/2019 12- Cytomegalovirus (CMV)
10/17
CMV and HIV-infection
Retinitis is the most common manifestation of CMV inpatients who are HIV-positive.
CMV-pneumonia in patients who are HIV-positive isuncommon.
Ulceration of GIT (esophagus and stomach) are associatedwith nausea, vomiting, dysphagia and abdominal pain.
Ulceration of the small intestine or colon may causeabdominal pain, diarrhea and gastrointestinal bleeding orperforation.
-
8/12/2019 12- Cytomegalovirus (CMV)
11/17
Diagnosis of CMV infection
Antigenemia test, testing for CMV-antigen.
PCR, has been used to detect CMV-DNA in the blood andtissue samples.
Biopsy, for demonstration of intranuclear inclusion bodies
Chest x-ray for CMV-pneumonia.
-
8/12/2019 12- Cytomegalovirus (CMV)
12/17
CMC-congenital infection.
The fetus is infected inside the uterus before ruptureof the fetal membrane.
The fetus is infected through the placenta. Most pregnant women are immune to CMV, due to
childhood exposure.
Most women who are infected during pregnancyhave no symptoms and very few have a diseaseresembling infectious mononucleosis.
-
8/12/2019 12- Cytomegalovirus (CMV)
13/17
-
8/12/2019 12- Cytomegalovirus (CMV)
14/17
Congenital infection .
-
8/12/2019 12- Cytomegalovirus (CMV)
15/17
Microcephaly .
-
8/12/2019 12- Cytomegalovirus (CMV)
16/17
Congenital infection .
The most severe form of congenital CMV infection isreferred to as cytomegalic inclusion disease ( CID ) .
CID occurs when women acquire primary CMVinfection during pregnancy ( especially in the firsthalf of pregnancy ).
CID is characterized by hepatosplenomegaly ,
thrombocytopenia, hemolytic anemia, microcephaly,chorioretinitis, petechiae, deafness and mentalretardation.
-
8/12/2019 12- Cytomegalovirus (CMV)
17/17
Congenital infection , Lab diagnosis .
By detection of CMV-DNA in urine , using PCR .