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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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