questions 3

Cytomegalovirus (CMV)

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Topic updated on 04/03/17 3:09pm

Human Herpes Virus Type 5
  • Classification
    • Virus
      • Enveloped
        • Herpesviridae
          • CMV (HHV-5)
  • Pathogenesis
    • transmission
      • congenital
      • transfusion
      • sexual contact
      • saliva
      • urine
      • transplant
    • molecular biology
      • latency in mononuclear cells
Diseases
  • Mononucleosis
    • negative monospot (heterophile negative)
    • most common infection in immunointact
  • Cytomegalic inclusion disease
    • most common in utero infection in U.S., highest risk to fetus during the first trimester
    • transmission is roughly 45% in first two trimesters, with higher rates in third trimester (75%)
    • 85-90% of congenitally infected children are asymptomatic at birth, including normal hearing
    • mother
      • asymptomatic or mononucleosis symptoms
    • neonate
      • jaundice
      • hepatosplenomegaly
      • thrombocytic purpura, petechia
      • hearing loss, most common cause of non-heriditary congenital sensorineural deafeness
      • seizures
      • microcephaly
  • CMV retinitis (shown)
    • in AIDS
    • "cotton-wool spots" on funduscopic exam
  • CMV colitis
    • important cause of bloody diarrhea in immunosuppressed patients
  • Pneumonia
    • in immunocompromised
  • Nosocomial infection
    • neonates in nursery
Laboratory
  • Infected cells have characteristic "owl's eye" appearance 
    • "sight-o-megalo virus"
    • Cowdry type A intranuclear inclusion bodies
  • Monospot test
  • Characteristics  
    • DNA
      • double-stranded
      • linear
    • enveloped
Treatment
  • Ganciclovir/foscarnet for immunocompromised only 


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(M1.MC.75) A 35-year-old HIV+ man presents to the ophthalmologist complaining of worsening vision for the past two weeks, and seeing new flashes and floaters in his right eye. He reports no pain in his right eye nor is there any redness. On ophthalmoscopic exam, the following is observed (Figure A). Which of the following best describes the virus responsible for these findings? Topic Review Topic
FIGURES: A          

1. Linear (+)ssRNA, nonenveloped
2. Linear (-)ssRNA, segmented, enveloped
3. Partial circular, dsDNA virus, enveloped
4. Linear dsDNA, enveloped
5. Circular dsDNA, nonenveloped

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