Acute cytomegalovirus (CMV) infection

Also known as: CMV mononucleosis and Cytomegalovirus (CMV)

Definition

Acute cytomegalovirus (CMV) infection is a condition caused by a member of the herpesvirus family.

See also: Mononucleosis

Causes, incidence, and risk factors

Infection with cytomegalovirus (CMV) is very common. The infection is spread by:

• Blood transfusions
• Organ transplants
• Respiratory droplets
• Saliva
• Sexual contact
• Urine

Most people are exposed to CMV in their lifetime, but typically only individuals with weakened immune systems become ill from CMV infection. Some people with this condition develop a mononucleosis-like syndrome.

In the U.S., CMV infection most commonly develops between ages 10 - 35. Most people are exposed to CMV early in life and do not realize it because they have no symptoms. People with a compromised immune system can have a more severe form of the disease.

Symptoms

• Enlarged lymph nodes, especially in the neck
• Fever
• Fatigue
• Loss of appetite
• Malaise
• Muscle aches
• Rash
• Sore throat

Less common symptoms include:

• Chest pain
• Cough
• Headache
• Hives
• Irregular heart beat
• Jaundice
• Neck stiffness
• Rapid heart rate
• Sensitivity to light
• Shortness of breath
• Swollen spleen and liver

Signs and tests

Your health care provider will perform a physical exam and feel your belly area. The liver and spleen may be tender when they are gently pressed (palpated). There may be a skin rash.

Special lab tests may be done to check for substances in your blood that are produced by CMV. Other tests will be done to check your body’s response to the CMV infection. This includes a CMV ELISA antibody test and CMV serum PCR test.

Other tests include:

• Blood tests for platelets and white blood cells
• Chemistry panel
• Liver function tests
• Monospot test

Treatment

Most patients recover in 4 - 6 weeks without medication. 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 medications are usually not used in people with normal immune function.

Expectations (prognosis)

Fever usually goes away in 10 days, and swollen lymph glands and spleen return to normal in 4 weeks. Fatigue may linger for 2 to 3 months.

Complications

Throat infection is the most common complication. Rare complications include:

• Colitis
• Guillain-Barré syndrome
• Neurologic complications
• Pericarditis or myocarditis
• Pneumonia
• Rupture of spleen

Calling your health care provider

Call for an appointment with your health care provider if you have symptoms of acute CMV infection.

Go to the emergency room or call the local emergency number (such as 911) if you have sharp, sudden pain in your left upper abdomen. This could indicate a ruptured spleen, which requires 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.

References

Crumpacker CS, Wadhwa S. Cytomegalovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 6th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2005: chap 134.

Drew WL. Cytomegalovirus. In: Goldman L, Ausiello D, eds. Cecil Medicine. 23rd ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 399.

See also:

• Symptoms

  Swollen lymph nodes

  

  Lymph nodes are found throughout your body. They are an important part of your immune system. Lymph nodes help your body recognize and fight germs, infections, and other foreign substances. The term “swollen glands” refers to enlargement of one or more lymph nodes. In a child, a node ...

Review date:

September 15, 2010

Reviewed by:

David C. Dugdale, III, MD, Professor of Medicine, Division of General Medicine, Department of Medicine, University of Washington School of Medicine; 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. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

Copyright Information

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org). URAC's accreditation program is an independent audit to verify that A.D.A.M. follows rigorous standards of quality and accountability. A.D.A.M. is among the first to achieve this important distinction for online health information and services. Learn more about A.D.A.M.'s editorial policy, editorial process and privacy policy. A.D.A.M. is also a founding member of Hi-Ethics and subscribes to the principles of the Health on the Net Foundation (www.hon.ch).

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- 2008 A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.