Cytomegalovirus infection symptoms in women treatment

Cytomegalovirus infection – what is it? Characteristics of the disease

Infectious cytomegalovirus (CMV) belongs to the group of herpes viruses, which includes chickenpox virus and herpes zoster virus, Epstein-Barr (causative agent of infectious mononucleosis). Viruses of this group have the same function after the initial infection they remain present in the body, and their subsequent manifestation is reflected in a weakened immune system (i.e., "latent infection"). As well as the herpes virus remains hidden in nerve cells, the CMV after primary infection intensive distributed mainly in the salivary glands, kidneys and white blood cells, where the nucleic acid of the virus and thus its genetic information (genome) remains throughout life.

Cytomegalovirus is a virus that is in the world is all-pervading, circulates among the people, and the population, to a large extent, a burden. Seroprevalence among the global population varies from 50% in developed countries to nearly 100% in developing countries where there is high population density and present the worst health status. At first glance, it may seem to someone disturbing, but the opposite is true. A high level of infection in the population means that people have against the virus developed antibodies, whereby the population is stable against him. Diagnosis of cytomegalovirus infection determines the type of disease – is it primary or not. Antibodies generated after primary infection (first contact with the virus), which in most people has no symptoms, therefore people are unaware of her presence. Rarely may develop such signs of cytomegalovirus infection, fever, inflammation of the Airways and elevated liver enzymes, indicating infection of the liver. But when it comes to the spread of the virus in the body, activates the immune system, and lymphocytes (type of white blood cells) secrete antibodies that protect humans from a possible future of cytomegalovirus infection, thus the body acquires immunity. This situation is typical for people with a healthy immune system. However, problems arise when the immune system due to certain reasons is weakened.

The transmission of the virus between humans requires close contact with a person who distinguishes this virus from the saliva, urine and other biological fluids. There is a possibility to become infected during sexual intercourse, but, very importantly, the virus is also passed from mother to fetus, intake throughout pregnancy (through the placenta), during delivery, and afterwards it may penetrate into breast milk. Therefore, the primary cytomegalovirus infection is dangerous, especially during pregnancy when the developing fetus infection can lead to serious damage. In addition, transmission can occur in organ transplants or blood transfusions.

Salivary gland disease and infection infection. Risk factors

A risk factor is any weakening of the immune system. In the case of organ transplantation, when a person takes drugs, and mutes the immunity in the case of AIDS, when the immune system is damaged in other similar cases. The risk also arises in the treatment of cancer. For immunocompromised individuals is extremely risky communication with infected persons may excrete the virus (so-called carriers), but for example, a blood transfusion.

Risk to the fetus is infection of the mother inpregnancy, especially if we are talking about primary disease.

Cytomegalovirus infection – symptoms

The symptoms of cytomegalovirus infections in women and men similar.

As mentioned above, a disease in healthy people, as a rule, proceeds without any visible clinical signs, as a healthy immune system can easily eliminate the virus. The situation is different in case of its weakening. This applies in particular to cases of organ transplantation and the presence of AIDS.

Transplantation (transfer of a donor organ to the recipient) the recipient body runs the so-called immunosupressed, which represents a deliberate weakening of the immune system which, therefore, can not attack the transplanted organ. This is because a foreign body and the immune system usually are not friendly to each other and, thus, there is a high risk of rejection. On the other hand, the risk of immunosuppression is increased susceptibility to infections and serious trends of infectious diseases. So is the case with CMV, which is either in a weakened organism, or even often present in the transplant organ or transfused blood. In this case, the disease can be severe, there is fever, reduced liver function and cytomegalovirus pneumonitis (lung inflammation), the disease can lead to death.

In AIDS there is a sharp loss of lymphocytes and, thereby, weakening the immune system. Cytomegalovirus in AIDS is the most common opportunistic infection (General infection which is harmless to healthy people, but in his weakened state the body causing problems). The most common form of AIDS is cytomegalovirus retinitis, can also be affected by the spinal nerve roots (poliradikulopatiâ), often manifest in peripheral paralysis of the limbs and problems with their sensitivity and painful inflammation of the peripheral nerves (neuropathy). If affected by the gastrointestinal tract, the person experiences pain and difficulty swallowing due to ulcers in the wall of the esophagus, inflammation of the colon (colitis) is suffering from diarrhoea. In addition, cytomegalovirus can cause inflammation of the pancreas (acute pancreatitis) or gallbladder (cholecystitis). Therefore, diagnosis of cytomegalovirus infection is an extremely important move.

Another serious problem is cytomegalovirus during pregnancy. Sometimes during pregnancy, most often in the last trimester comes to reactivation of latent infection and therefore, infection of the fetus during childbirth. Healthy full term infants infection mostly occurs without symptoms. In children premature or immunocompromised, may experience various diseases such as pneumonia, diseases of the gastrointestinal tract, or sepsis (severe systemic symptoms). Fortunately, when you reactivate a latent infection the risk of infection of the fetus, is relatively small – about 1%.

The greatest danger is a primary infection during pregnancy, which practically can not be treated, and is the most risky in the first trimester and more than 10% of cases, can lead to serious damage to the fetus. Infection of the fetus is called "congenital infection". If confirmed the infection of the fetus, it is recommended an abortion, because the treatment of cytomegalovirus infection at this time is impossible and inefficient. Congenital infection can lead to fetal death, the establishment of congenital malformations of the brain, heart and eye, hearing and mental retardation (a General slowing of development). In addition, a common infection in newborns leads to low body weight at birth, jaundice, anemia, bleeding, enlarged liver and spleen, inflammation of the lungs. Alarming results of recent studies have shown that about one-third of women in our country have not established antibodies against cytomegalovirus, and therefore they are threatened by the risks described above.

Congenital infection of cytomegalovirus

Congenital cytomegalovirus in children is a fairly common phenomenon when the initial infection occurs through the placenta, about 1/3-1/5 of the cases. Re-infections occur in only 1% of fetuses. The disease is more serious in children neironnykh mothers. Affected mainly the liver, brain and blood.

The symptoms are similar to manifestations of congenital toxoplasmosis. The fruit has an enlarged liver and spleen (hepatosplenomegaly), jaundice, increase of cerebrospinal fluid in the ventricles of the brain (hydrocephalus) and early cessation of brain growth (microcephaly), suffer from inflammation of the brain tissue, growing deafness and disorders in mental development. Violation of hematopoiesis leads to a decrease in the number of platelets that is manifested by a punctuate bleeding of the skin (petechia). Cytomegalovirus infection can cause recurrent miscarriages and stillbirth.

Cytomegalovirus infection in adults

In healthy individuals CMV infection occurs withoutsymptoms are rarely seen with infectious mononucleosis. The main and almost the only symptom may be high fever, persisting for several weeks. Swelling of neck and lymph nodes in the cervical region, usually expressionless, more often than tonsillitis, pharyngitis is present. As a rule, are of nonspecific flu-like symptoms, such as malaise, fatigue, headache and muscle pain, rash and mild enlargement of the liver and spleen. The necessary diagnosis, cytomegalovirus infection often leads to inflammation of the liver, but also speech can go about separate disease that tends to progress, and be accompanied by vomiting, but can also occur without symptoms or, conversely, with severe inflammation, jaundice and hepatic insufficiency. The liver is enlarged.

Infection after transplantation and blood transfusion

Cytomegalovirus infection after kidney transplantation, liver and heart develops in 60-100% of cases. The source in this case is the transplanted organ or blood, which includes the cytomegalovirus. The clinical picture can include a constant high temperature, as in infectious mononucleosis, or a severe inflammatory disease with fever, liver disease, colon, diarrhea, and pneumonia. Infection after transplantation is causing the worst survival rate of transplant.

Serious progress has the disease in recipients of bone marrow. In the second month after transplantation cytomegalovirus pneumonia occurs with a very poor prognosis.

Transmission by blood transfusion is called a syndrome perfusion. Manifested by fever, swollen lymph nodes and liver.

The presence of HIV infection

Cytomegalovirus causes HIV-positive people inflammation lgkih, brain, retina and gastrointestinal tract. The virus acts as a catalyst for the progression of AIDS. In people with AIDS, CMV infection is often the cause of early death.

Cytomegalovirus retinitis is usually the first symptom of infection of the whole body. Disease characterized by blurred vision, progressive disabling the field of view and, ultimately, vision loss. Comes to the local extinction of the retina. Untreated inflammation leads to loss of vision within six months. The disease is often accompanied by inflammation of the brain tissue.

Cytomegalovirus inflammation of lumbar and sacral nerves (lumbosacral progressive polyneuropathy) is a late complication of HIV infection. Manifested a rapidly growing movement disorder of the lower extremities, sensory failure, leakage of urine and feces.

In the case of lesions of the gastrointestinal tract ulcers, duodenal ulcer, manifested by painful and difficult swallowing. Inflammation of the colon accompanied by fever and bloody diarrhea. Could be a bowel. Ulcers in the mouth and on the lips don't close easily, they are very painful and irritating.

Prevention of CMV

Prevention is strict adherence to standard hygienic principles, the study of donors of blood and organs, the exclusion of infected donors, especially in the case of non-immune recipients. Pregnant women with primary CMV infection, it is recommended to terminate the pregnancy.

Vaccination is not, but in this area is to carry out clinical research.

Diagnostics cytomegalovirus infection and its definition

CMV infection is most often determined from a blood sample of the patient by identifying specific antibodies that begin to take shape at the age of 3 to 4 weeks after primary or recurrent infection. First of all, the formation of IgM antibodies – they indicate active infection, and after treatment disappear. Later, IgG antibodies are produced – they are at a low level remains in the body lifelong, thus pointing to the fact that the person ever had cytomegalovirus infection.

Direct diagnosis of the virus in the body is performed using molecular biological methods, mainly PCR, where CMV can be isolated from urethral, vaginal, cervical secretions, semen, urine, saliva, blood, or rectal swabs.

Treatment cytomegalovirus infection and therapeutic methods

People with well functioning immune system is assigned to symptomatic treatment, reduce the symptoms of cytomegalovirus infection. In individuals with a weakened immune system (immunodeficiency, HIV, post-transplant), when there is severe infection, enter the target treatment of cytomegalovirus infection using antiviral drugs.

Treatment cytomegalovirus infection and symptomatic therapy

The mainstay of treatment is quiet mode, avoiding exercise and light diet. As a support used vitamins and hepatoprotectors, although their admission is not clearly recognized. Of herbs you can drink tea made from milk Thistle, which leads to leaching of the same material as the above medications. To reduce the high temperature enter the receptionantipyretic drugs.

Antiviral therapy of cytomegalovirus infections — treatment of underlying problem

Cytomegalovirus infection antiviral treatment directions aimed at preventing the formation of viral DNA and reproduction of viruses. This is a very expensive preparations used by people who really need them, in particular, patients with immune system disorders. Proved its antiviral action Ganciclovir and Foscarnet. These drugs not only serve for treatment but in some cases, and for the prevention of cytomegalovirus infection. In case of serious and long-lasting immune disorders prevention can be applied throughout life.

Introduction antiviral drugs for people after a bone marrow transplant is controversial. Ganciclovir can worsen the absolute lack of neutrophils and platelets. Other antiviral drugs are toxic to the kidneys.

The symptoms and treatment of CMV how to help themselves?

During the disease should keep sufficient fluid intake, if there is high temperature, it can be reduced by applying cold compresses in the armpits and groin area. It should be borne in mind that fever is a response to infection and helps kill the virus so no need to knock it, if it is not too high, do not try at any cost to reduce.

Complications of cytomegalovirus infection

Primary cytomegalovirus infection can occasionally even in healthy people to cause a condition resembling infectious mononucleosis syndrome, manifested by fever and swollen lymph nodes.

Other complications include pneumonia (interstitial pneumonitis), Guillain-Barre syndrome (inflammation of a nerve root that is most often seen disorders of sensation and movement of limbs), meningitis and encephalitis, inflammation of the heart (myocarditis), and skin infections.

Recommendations

HIV-positive people have to undergo periodic eye examination to determine the presence of cytomegalovirus retinitis and start a treatment aimed at preventing loss of vision.