Presentation
Time from DMEK to presentation ranged from 5 to 15 weeks. Presenting features included corneal edema, pigmented keratic precipitates, mild anterior chamber inflammation, and raised intraocular pressure. [ncbi.nlm.nih.gov]
Special techniques help to confirm the presence of multiple organisms, especially if more than one virus is present. [histopathology-india.net]
Immune System
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Splenomegaly
Hemophagocytic lymphohistiocytosis was diagnosed because our patient had elevated levels of serum ferritin, bicytopenia, splenomegaly, fever ( 38.5 C), and hemophagocytosis shown in a bone marrow sample. [ncbi.nlm.nih.gov]
Children born with congenital CMV infection may present with hepatomegaly, splenomegaly, jaundice, pneumonitis, fetal growth retardation, petechiae, purpura, and thrombocytopenia. [orpha.net]
In 95% of cases this occurs without symptoms, but some neonates may present jaundice, hepato-splenomegaly and retarded psycho-motorial development. [diesse.it]
CMV may also produce a mononucleosis syndrome similar to Epstein-Barr virus (causing a febrile illness with splenomegaly, impaired liver function and abnormal lymphocytes in the blood) but without characteristic pharyngitis and lymphadenopathy. [patient.info]
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Cervical Lymphadenopathy
Cervical lymphadenopathy is less commonly seen in heterophile-negative mononucleosis.The results of liver function tests are abnormal. [atsu.edu]
EBV Mononucleosis syndrome associated with CMV infection differs from that caused by EBV. 13% – 17% patients with CMV-mononucleosis present with cervical lymphadenopathy, vs. 80% with EBV-associated mononucleosis. [pedclerk.bsd.uchicago.edu]
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Generalized Lymphadenopathy
When clinical manifestations are present, they include: malaise, fever, generalized lymphadenopathy, and hepatosplenomegaly. [perinatology.com]
Fatigue and malaise may persist for 4 weeks or longer. 12 Physical examination shows cervical or generalized lymphadenopathy. Rarely, hepatomegaly, splenomegaly, or rash may develop. Jaundice is uncommon. [glowm.com]
Entire Body System
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Fever
Hematochezia was more common in IBD patients (84.0% vs. 35.1%; p .001), but fever and positive CMV antigenemia were more common in non-IBD patients (50.9% vs. 12.0%; p .001; 54.4% vs. 28.0; p .027). [ncbi.nlm.nih.gov]
Both CMV and EBV mononucleosis cause fever and fatigue. But EBV also causes a severe sore throat. CMV does not. [merckmanuals.com]
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Infectious Mononucleosis
Infectious mononucleosis is caused by the Epstein-Barr virus. It is a viral infection causing high temperature, sore throat, and swollen lymph glands. [mountsinai.org]
This study aimed to evaluate the cause of EBV and CMV IgM dual positivity to determine whether it represents a false-positive finding or a true coinfection.A total of 494 children diagnosed with primary EBV infection, manifesting as infectious mononucleosis [ncbi.nlm.nih.gov]
Those who develop symptoms may experience an illness resembling infectious mononucleosis and have fever, swollen glands and feel tired. [www1.nyc.gov]
It is related to the viruses that cause chickenpox and infectious mononucleosis (mono). Between 50 percent and 80 percent of adults in the United States have had a CMV infection by age 40. Once CMV is in a person's body, it stays there for life. [medlineplus.gov]
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Malaise
These may include: Enlarged lymph nodes, especially in the neck Fever Fatigue Loss of appetite Malaise Muscle aches Rash Sore throat CMV can cause infections in different parts of the body. Symptoms vary depending on the area that is affected. [nlm.nih.gov]
The major symptoms of the disease in organ transplant recipients include fever, myalgia, malaise, arthralgia, leucopenia, thrombocytopenia, and hepatitis. [canada.ca]
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Fever of Unknown Origin
[…] of unknown origin who was referred to a tertiary hospital.19 Her liver enzyme levels were elevated, and an abdominal CT scan was consistent with acute hepatitis. [mja.com.au]
Symptomatic CMV disease can affect almost every organ of the body, resulting in fever of unknown origin, pneumonia, hepatitis, encephalitis, myelitis, colitis, uveitis, retinitis, and neuropathy. [emedicine.medscape.com]
Gastrointestinal
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Nausea
We describe a 88-year-old male presenting with a week-long history of intractable abdominal discomfort, bloating, nausea and diarrhea. Flexible sigmoidoscopy revealed significant ulceration with yellowish slough. [ncbi.nlm.nih.gov]
Gastrointestinal symptoms include nausea and epigastric pain when the infection is in the stomach or duodenum, and severe diarrhea and cramps when it is located in the lower gastrointestinal tract. [hematologyandoncology.net]
People whose immune systems are compromised, on the other hand, are usually treated with the antiviral drug ganciclovir, which can sometimes cause nausea, a lowered testosterone level, and a decrease in the white blood cells called neutrophils. [consumer.healthday.com]
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Vomiting
A 56-year-old man was admitted to the hospital reporting 5 months of progressive ascending lower extremity weakness and numbness, inability to walk, bowel incontinence,urinary retention and several episodes of nausea and vomiting. [ncbi.nlm.nih.gov]
Symptoms can include painful and difficult swallowing, nausea, vomiting, abdominal pain, yellow skin and watery or bloody diarrhea. [drugs.com]
She had suffered from vomiting and diarrhea for the last two weeks. [scielo.isciii.es]
Symptoms of CMV-related upset in the upper and lower GI tract include: Difficulty swallowing Inflammation of the esophagus Nausea Vomiting Diarrhea Jaundice/hepatitis Pancreatitis, i.e. inflammation of the pancreas Colitis; inflammation of the colon Cholecystitis [ada.com]
Cardiovascular
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Heart Block
However, our patient developed transient heart block as a rare complication for Ganciclovir therapy throughout his course. [ncbi.nlm.nih.gov]
Jaw & Teeth
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Periodontitis
KEYWORDS: HCMV; cytomegalovirus; herpes; keratinocyte; lytic; oral; pentamer; periodontal [ncbi.nlm.nih.gov]
Jørgen Slots, Human viruses in periodontitis, Periodontology 2000, 53, 1, (89-110), (2010). [doi.org]
Liver, Gall & Pancreas
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Hepatomegaly
On examination, the neonate was found to have respiratory distress, an extensive rash (Panel A), and hepatomegaly. [doi.org]
Babies who are infected with CMV before birth are at higher risk of several defects such as microcephaly (small head size), hepatomegaly (enlarged liver), jaundice (yellow color of skin and eyes), anemia (low blood count), pneumonia, seizures, vision [birthdefects.org]
Children born with congenital CMV infection may present with hepatomegaly, splenomegaly, jaundice, pneumonitis, fetal growth retardation, petechiae, purpura, and thrombocytopenia. [orpha.net]
Symptomatic newborns present with a variety of abnormalities including low birth weight, microcephaly, seizure, chorioretinitis hepatomegaly, hepatitis, jaundice, thrombocytopenia, petechiae, and characteristic “blueberry muffin” rash due to increased [pedclerk.bsd.uchicago.edu]
Skin
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Yellow Discoloration of the Skin
Hepatitis B can cause inflammation of the liver, and in the earliest stage of the disease, infected people may feel ill or even have yellow discoloration of the skin or eyes, a condition known as jaundice. [web.archive.org]
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Papule
The rash consisted of purple-to-magenta, nonblanching macules that were 0.5 to 1.0 cm in diameter, as well as papules and petechiae covering her entire body. [doi.org]
Neurologic
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Guillain-Barré Syndrome
Rare complications include: Colitis Guillain-Barré syndrome Nervous system (neurologic) complications Pericarditis or myocarditis Pneumonia Rupture of the spleen Inflammation of liver (hepatitis) When to Contact a Medical Professional Call for an appointment [ufhealth.org]
[…] in a Normal Person Common Less common Rare Asymptomatic* Exudative pharyngitis Icteric hepatitis Mononucleosis syndrome Splenomegaly Guillain-Barré syndrome Fever Cervical adenopathy Encephalitis Malaise Nonspecific rash Myocarditis Sore throat Anemia [aafp.org]
Complications of infection are uncommon in immunocompetent hosts but include: Guillain-Barré syndrome. Meningoencephalitis. Pericarditis. Myocarditis. Thrombocytopenia. Haemolytic anaemia. [patient.info]
Rarer manifestations of CMV infections in immunocompetent individuals include Guillain-Barré syndrome, meningoencephalitis, pericarditis, myocarditis, thrombocytopenia, and hemolytic anemia. [emedicine.medscape.com]
Workup
A negative pulmonary workup led to an endomyocardial biopsy and the diagnosis of cytomegalovirus (CMV) myocarditis. The patient was treated with ganciclovir and intravenous immunoglobulin. [ncbi.nlm.nih.gov]
The infectious disease team was consulted, and a thorough workup was completed. JD tested negative for syphilis, influenza, Epstein-Barr virus, herpes simplex virus, and Lyme disease. [journals.lww.com]
"Cytomegalovirus (CMV) Workup." Medscape.com. May 5, 2018. . Azevedo, L.S., et al. "Cytomegalovirus infection in transplant recipients." Clinics (Sao Paulo) 70.7 July 2015: 515-23. doi: 10.6061/clinics/2015(07)09. Epub 2015 Jul 1. Review. [medicinenet.com]
Skin Test
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Anergy
PD-1 expression and IL-2 loss of cytomegalovirus- specific T cells correlates with viremia and reversible functional anergy. Am J Transplant, 8 (2008), pp. 1486-1497 [6.] A.A. Rahman, M. Teschner, K.K. Sethi, H. Brandis. [elsevier.es]
PD-1 expression and IL-2 loss of cytomegalovirus- specific T cells correlates with viremia and reversible functional anergy. Am. J. [frontiersin.org]
Colonoscopy
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Colitis
CONCLUSIONS: In active CMV colitis, the specificity and negative predictive value of blood PCR are high, while the sensitivity grows with the intensity of colon infection. [ncbi.nlm.nih.gov]
PubMed Search: CMV colitis[TI] OR cytomegalovirus colitis[TI] colon Advertisement Page views in 2018: 8,804 Page views in 2019 to date: 1,926 Cite this page: Bansal N. Cytomegalovirus (CMV) colitis. PathologyOutlines.com website. . [pathologyoutlines.com]
Clinical Characteristics of CMV Colitis in the Immunocompetent Host Klauber et al. [39] reported 15 immunocompetent adults with CMV colitis. [karger.com]
Other Pathologies
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Viral Inclusion Body
Histological examination of the gallbladder wall was positive for multiple viral inclusion bodies. [ncbi.nlm.nih.gov]
The pathologic hallmark of CMV infection is an enlarged cell with viral inclusion bodies. Cells that exhibit cytomegaly are also seen in infections caused by other Betaherpesvirinae. [emedicine.medscape.com]
Treatment
Antibiotic treatment was started; he was intubated and artificially ventilated. Norepinephrine infusion was started. [ncbi.nlm.nih.gov]
Prognosis
The syndrome mainly affects children and young adults; the prognosis is favorable with complete or nearly complete neurological and radiological resolution within days or weeks. [ncbi.nlm.nih.gov]
HCMV and tumor-infiltrating T cells Using immunohistochemical staining, quantitative PCR, and large-scale flowcytometry, recent studies have demonstrated the critical role of localized adaptive immune reaction in the prognosis of cancer behavior and prognosis [doi.org]
Etiology
Etiology and causality of HCMV infection with IBC now needs to be rigorously examined. [ncbi.nlm.nih.gov]
Epidemiology
Abstract Purpose: Recent epidemiological data indicate that a history of increased exposure to sexually transmitted diseases is associated with an increased risk of prostate cancer. [doi.org]
This leads to marked alterations in the composition of the immune cell repertoire and epidemiological evidence shows that this can be associated with increased levels of morbidity and mortality in the elderly. [ncbi.nlm.nih.gov]
Pathophysiology
The exact pathophysiology is unknown; however, infectious-related MERS (in particular virus associated MERS) remains the most common cause of reversible splenial lesions in childhood. [ncbi.nlm.nih.gov]
Useful For Suggests clinical disorders or settings where the test may be helpful Aiding in the diagnosis of acute or past infection with cytomegalovirus (CMV) Determination of prior exposure to CMV Clinical Information Discusses physiology, pathophysiology [mayomedicallaboratories.com]
[…] can be acquired during birth, breast feeding, close contact, sexual contact, transfusion or with organ transplant ( Scand J Gastroenterol 2010;45:1295 ) Sites Most common sites of CMV related gastrointestinal involvement are the esophagus and colon Pathophysiology [pathologyoutlines.com]
Prevention
Although available anti-CMV therapies may be effective for the prevention of CMV, they are plagued by unacceptable toxicities that prohibit their use in the post-transplant period. [ncbi.nlm.nih.gov]
Scientists are working on CMV vaccines and are looking for other ways to prevent congenital CMV infection. [sites.google.com]