Chap 166 -- Cmv
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CHAPTER 166 CYTOMEGALOVIRUS -
beta herpes virus
-
grows preferentially in fibroblast
HALLMARK: appearance of atypical lymphocytes in the peripheral blood; activated by CD8 T lymphocytes Transmission: Blood transfusion or organ transplantation PATHOLOGY: “owl’s eye “ appearance-inclusion body 1) Congenital CMV - petechiae, hepatosplenomegaly, jaundice - poorprognosis - significant psychomotor, hearing, ocular, dental abn\ 2) Perinatal CMV -passage thru an infected birth canal, postnatal breast milk, maternal secretions -protracted interstitial pneumonitis 3) CMV Mononucleosis -heterophil antbody- antigen mononucleosis syndrome 4) on immunocompromised host - most common and important viral pathogen -period of maximal risk between 1 to 4 months after transplant CMV pneumonia- 5 to 13 wks CMV retinitis- important cause of blindness w/ AIDS DX: isolation of virus: detection of CMC ag or DNA from appropriate clinical specimen Detection of CMV viremia- better predictor of acute infection CMV antigen – pp65- may hasten dx of CMV Tx: Prophylactic measure: -use of blood from seronegative donors -use of frozen, thawed, deglycerolized blood -CMV Ig -Acyclovir/gancyclovir HHV 6- exanthema subitum/ roseola infantum
beta herpes virus
-
grows preferentially in fibroblast
HALLMARK: appearance of atypical lymphocytes in the peripheral blood; activated by CD8 T lymphocytes Transmission: Blood transfusion or organ transplantation PATHOLOGY: “owl’s eye “ appearance-inclusion body 1) Congenital CMV - petechiae, hepatosplenomegaly, jaundice - poorprognosis - significant psychomotor, hearing, ocular, dental abn\ 2) Perinatal CMV -passage thru an infected birth canal, postnatal breast milk, maternal secretions -protracted interstitial pneumonitis 3) CMV Mononucleosis -heterophil antbody- antigen mononucleosis syndrome 4) on immunocompromised host - most common and important viral pathogen -period of maximal risk between 1 to 4 months after transplant CMV pneumonia- 5 to 13 wks CMV retinitis- important cause of blindness w/ AIDS DX: isolation of virus: detection of CMC ag or DNA from appropriate clinical specimen Detection of CMV viremia- better predictor of acute infection CMV antigen – pp65- may hasten dx of CMV Tx: Prophylactic measure: -use of blood from seronegative donors -use of frozen, thawed, deglycerolized blood -CMV Ig -Acyclovir/gancyclovir HHV 6- exanthema subitum/ roseola infantum
