CYTOMEGALOVIRUS DISEASE. In normal hosts: (a) If acquired by contact -- 1 o attack is asymptomatic or mononucleosis with subclinical hepatitis. (b) If by transfusion -- “post-transfusion syndrome”: fever and mononucleosis, FUO, granulomatous hepatitis.
In normal hosts:
In hosts with impaired T-cell immunity and in fetuses:
2. Sexual contact
4. Organ transplant (usually renal)
Difficult on clinical data alone…viral culture (2-4 weeks), serology by indirect immunofluorescence, cytology on concentrated urine
The antiviral drugs, cidofovir and ganciclovir, are the drugs of choice for CMV retinitis and pneumonitis- ganciclovir is more toxic than cidofovir.
Experimental live attenuated vaccines are being developed but unknown efficacy or safety.
1. Cell Culture: Cell rounding > fusion > giant cell formation (HSV)
2. Immunofluorescence: Intense nuclear staining for all herpesviruses
3. ELISA and Western Blot: Specificity based on glycoprotein
5. TORCH: Serologic assay
Herpes Simplex H