Presentation
The present case illustrates that disseminated cytomegalovirus infection with atypical clinical features should be included in the spectrum of the hyper-IgM syndrome. [ncbi.nlm.nih.gov]
We describe a patient with a history of chronic myelogenous leukemia (treated with chemotherapy) who presented with recurrent unexplained fevers and an acute abdomen. [scholars.northwestern.edu]
Entire Body System
- Fever
We describe a patient with a history of chronic myelogenous leukemia (treated with chemotherapy) who presented with recurrent unexplained fevers and an acute abdomen. [scholars.northwestern.edu]
He presented with prolonged fever, weight loss of 8 kg, anicteric hepatitis, upper digestive tract bleeding from gastric ulcers, acute polyneuritis and bilateral retinitis. [ncbi.nlm.nih.gov]
Physical exmination: The patient has intermittent fever with peak-temperature of 38.5 C (axillary). General appearance: cachexic and moderately dehydrated. [med.cmu.ac.th]
Case reports Case 1 A 66-year-old woman presented with high grade fever and fatigue for 1 month. Three weeks after the presence of fever, she developed asymptomatic skin rashes on the extremities. [symbiosisonlinepublishing.com]
- Weight Loss
He presented with prolonged fever, weight loss of 8 kg, anicteric hepatitis, upper digestive tract bleeding from gastric ulcers, acute polyneuritis and bilateral retinitis. [ncbi.nlm.nih.gov]
Symptoms include fever, diarrhea, weight loss, pain in the abdomen (or belly) and general feeling of being unwell. diseases of the central nervous system (CNS) —when CMV infects the brain and spinal cord. [catie.ca]
In addition, categories of CMV infections characterized as severe included any CMV infection causing vascular thrombosis; weight loss of over 10 kg; a vasculitic rash; perineal ulcers; or an eruption consisting of numerous vesicular or pustular lesions [virologyj.biomedcentral.com]
Case Presentation A 22-year-old Saudi female presented with right abdominal pain for the last two months, with history of anorexia and weight loss. [jpma.org.pk]
However, many patients suffer from systemic symptoms such as fever and weight loss. Diagnosis Diagnosis is made by fundoscopy. Assessment of the usually peripheral, whitish exudates is dependent on the experience of the ophthalmologist. [hivbook.com]
- Malaise
Clinical features are low grade fever, weight loss, anorexia, malaise, and abdominal pain, or diarrhea [ 5 ]. It may be responsible for severe complications, such as GI bleeding or perforation [ 24 ]. [omicsonline.org]
Of the patients with primary CMV infections, clinical and laboratory findings included abnormal liver function tests in 69%, malaise 67%, sweats 46%, fever 46%, muscle aches 36%, respiratory symptoms 28%, lymphadenopathy 24%, arthralgias 17% and headache [antimicrobe.org]
- Chills
Some of these patients had non-specific symptoms, such as fever, myalgia, asthenia, chills, or cough. The virus affected the eyes in 16 immunocompetent patients, who developed uveitis, retinitis, corneal endothelitis, or papillitis. [virologyj.biomedcentral.com]
Gastrointestinal
- Diarrhea
Abstract A 48-yr-old man with profuse diarrhea for about 9 mo was found to have intestinal cryptosporidiosis. Treatment with antibacterial, antimalarial, and other antiprotozoal agents failed to control the disease. [ncbi.nlm.nih.gov]
Falchuk, K.R. et al. intestinal cryptosporidiosis, man with persistent, profuse diarrhea, case report, complicated by disseminated cytomegalovirus infection, organisms identified in duodenal biopsy specimen by light and electron microscopy: Massachusetts [agris.fao.org]
Chiang Mai University, Thailand Patient : 7-month-old male infant CC: fever and diarrhea for 2 months PI: 2 months PTA, he has been repeatedly hospitalized at a primary care hospital with a diagnosis of "infectious diarrhea". [med.cmu.ac.th]
Intestinal necrosis and ulceration can develop and be extensive, leading to the formation of pseudomembranes and debilitating diarrhea. [humpath.com]
Symptoms include fever, diarrhea, weight loss, pain in the abdomen (or belly) and general feeling of being unwell. diseases of the central nervous system (CNS) —when CMV infects the brain and spinal cord. [catie.ca]
- Nausea
Symptoms of this complication can include fever, nausea, painful swallowing and swollen lymph nodes. colitis —when CMV infects the colon (the longest part of the large intestine). [catie.ca]
The symptoms observed in patients with CMV involvement of the GIT included fever, diffuse abdominal pain, or pain located in the lower abdominal quadrants, anorexia, nausea, vomiting, weight loss, watery or bloody diarrhoea, haematochezia, and melaena [virologyj.biomedcentral.com]
Clinical manifestations are dysphagia, odynophagia, substernal discomfort, nausea and vomiting [ 24 - 26 ]. [omicsonline.org]
Other less common adverse effects associated with foscarnet therapy include nausea, genital ulcers, anemia, nephrogenic diabetes insipidus, hypokalemia, hypomagnesemia, and central nervous system abnormalities, including seizure. [hivinsite.ucsf.edu]
Other side effects of ganciclovir include rash, nausea, fever, vomiting, anemia, diarrhea, eosinophilia, confusion, seizures, and psychotic reactions in a small number of patients ( 25 ). [antimicrobe.org]
- Vomiting
The symptoms observed in patients with CMV involvement of the GIT included fever, diffuse abdominal pain, or pain located in the lower abdominal quadrants, anorexia, nausea, vomiting, weight loss, watery or bloody diarrhoea, haematochezia, and melaena [virologyj.biomedcentral.com]
Clinical manifestations are dysphagia, odynophagia, substernal discomfort, nausea and vomiting [ 24 - 26 ]. [omicsonline.org]
CMV hepatitis Is defined by findings such as fever, vomiting, with hepatomegaly with hepatalgia, and atypical lymphocytosis may be approximately 50%, elevated bilirubin and/or enzyme levels, and detection of CMV by histopathologic analysis within the [intechopen.com]
Other side effects of ganciclovir include rash, nausea, fever, vomiting, anemia, diarrhea, eosinophilia, confusion, seizures, and psychotic reactions in a small number of patients ( 25 ). [antimicrobe.org]
- Acute Abdomen
We describe a patient with a history of chronic myelogenous leukemia (treated with chemotherapy) who presented with recurrent unexplained fevers and an acute abdomen. [scholars.northwestern.edu]
- Gastropathy
Less frequently, CMV may also be the cause of gastritis, Ménétrier’s disease (protein-losing hypertrophic gastropathy) and ileitis [ 19 ]. [omicsonline.org]
Skin
- Petechiae
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. [nejm.org]
The most common clinical findings of congenital CMV infection include petechiae (71%), jaundice (67%), microcephaly (53%), and small size for gestational age (50%). [emedicine.medscape.com]
Infants born small for gestational age with manifestations including petechiae, jaundice hepatosplenomegaly, microcephaly and hearing loss are termed to have cytomegalic inclusion disease and are at greatest risk for having severe long-term neurologic [antimicrobe.org]
Workup
Sepsis workup revealed negative result. He recieved intravenous antibiotics for 7 days. > At 2 month old (5 months PTA) he had another episode of "sepsis" with pneumonia. He was treated as bacterial and pneumocystis carrinii pneumonia. [med.cmu.ac.th]
See Workup for more detail. Management Healthy people who are infected with CMV but who have no symptoms usually do not require medical treatment. [emedicine.medscape.com]
Treatment
Disseminated infection with cytomegalovirus developed during treatment, and the patient died. Five other instances of intestinal cryptosporidiosis have been reported. [ncbi.nlm.nih.gov]
Local treatment Several options for local treatment of CMV retinitis have been tested (review in: Smith 1998). [hivbook.com]
Disseminated cytomegalovirus (CMV) infection complicating active treatment of systemic lupus erythematosus: an emerging problem. [sclero.org]
Antiretroviral therapy (ART)was added on day 12 of gangciclovir treatment. [med.cmu.ac.th]
Prognosis
However, recent studies imply positivity of this method in the disease prognosis[ 54 ]. [wjgnet.com]
[…] infection of the eye, a common opportunistic infection in AIDS, a complication of disseminated CMV infection Clinical Retinal inflammation, blindness Management Antivirals–eg, foscarnet, cidofovir, gancyclovir, systemically and as a ganciclovir implant Prognosis [medical-dictionary.thefreedictionary.com]
Positive CMV PCR is also independently associated with a poor prognosis for the patient (Deayton 2004, Jabs 2005, Wohl 2005). [hivbook.com]
The prognosis is extremely severe; hence a prompt diagnosis and an appropriate condition management are highly important [ 29 ]. [omicsonline.org]
Etiology
McKee's Pathology of the Skin is the most complete, in-depth resource on dermatopathology, covering etiology, pathogenesis, disease mechanisms, and recent genetic, molecular, and basic science data. Drs. J. [books.google.com]
CMV prevalence in CD Seropositivity in CD patients is as high as in other populations (70%)[ 64, 65 ], however CMV disease is rare in CD, making the virus an unlikely etiological factor in the novo development of IBD[ 27, 64, 66, 67 ]. [wjgnet.com]
Inflammatory Bowel diseases (IBD), which include ulcerative colitis (UC) and Crohn's disease (CD), consist of chronic, non-specific inflammatory diseases of unknown etiology that affect the digestive tract and can be differentiated mainly due to the depth [journals.plos.org]
Epidemiology
Congenital cytomegalovirus infection: review of the epidemiology and outcome. Obstet Gynecol Surv. 2002; 57 :245–256. [ PubMed ] [ Google Scholar ] 8. Fowler KB, Stagno S, Pass RF. [ncbi.nlm.nih.gov]
731499355056816128 Transmission Cytomegalovirus (CMV) associated with gasto intestinal perforation. https://twitter.com/ARP_Press/status/949018833695715328 CMV inclusions / CMV nuclear inclusions https://twitter.com/Hopkins_GI_Path/status/949034221502427137 Epidemiology [humpath.com]
In Morocco, Data concerning epidemiologic profile of CMV disease are lacking; there is a huge need of cohort studies in this field [ 1 ]. [omicsonline.org]
Introduction Early in the AIDS epidemic, cytomegalovirus (CMV) was a major cause of morbidity and mortality in patients with AIDS in the United States.(1) Epidemiologic studies indicated that through 1992 nearly half of HIV-infected patients eventually [hivinsite.ucsf.edu]
Epidemiology of tuberous sclerosis. Ann N Y Acad Sci 1991; 615:125. 5. Levy, M, Feingold, J. Estimating prevalence in single-gene kidney diseases progressing to renal failure. Kidney Int 2000; 58:925. 6. Rose, VM, Au, KS, Pollom, G, et al. [ispub.com]
Pathophysiology
The pathophysiology of a disease may compromise the immune system. [journals.plos.org]
Hommes et al[ 94 ] proposed the following sequence to explain the pathophysiology of CMV disease in patients with active UC: (1) initiation phase, mucosal inflammatory response induces expression of cytokines and chemokines which activates latently infected [wjgnet.com]
Pathophysiology Causal agent CMV or HHV-5 (type 5 of Human Herpes Virus) is a double-stranded DNA virus. It is the largest of the human herpes viruses with a 230 kb genome encoding 165 genes [ 11 ]. [omicsonline.org]
The pathophysiology of HPS is not completely understood there is an activation of lymphohistiocytic tissue secondary to hypercytokinemia derived from the activation of T lymphocytes and activated macrophages, causing fever, shock, and organ dysfunction [intechopen.com]
Pathophysiology CMV is a lytic virus that causes a cytopathic effect in vitro and in vivo. The pathologic hallmark of CMV infection is an enlarged cell with viral inclusion bodies. [emedicine.medscape.com]
Prevention
The observation suggests that replicative CMV infection in organ-transplanted patients may be suppressed by relatively low dose ganciclovir, even when the patients are maintained on immunosuppressive regimens designed to prevent graft rejection. [ncbi.nlm.nih.gov]
Special attention is given to the prevention and treatment of these diseases found in developing countries as well as the latest findings about new antimicrobial agents, gram-negative infections and their management, and recommendations for immunization [books.google.com]
Good hygiene, including proper hand washing, may help prevent infections. [icdlist.com]
Preventing recurrence Once the CMV-related disease has subsided, your doctor will likely recommend that you take medication to prevent the infection from returning. [catie.ca]
CMVIG was found to be unsuccessful in the prevention of CMV disease. [antimicrobe.org]