Cytomegalovirus Disease (CMV)
What is cytomegalovirus (CMV)? — Cytomegalovirus is a virus that can cause a fever, loss of energy, and other symptoms. Doctors also call it "CMV."
CMV is very common. Many people have the virus without knowing it. Some people don't get sick when they have it, but others do.
CMV can cause serious illness in people with conditions that weaken the body's infection-fighting system (called the "immune system"). These conditions include:
An organ transplant, such as a new kidney or lung
A stem cell transplant – Stem cells are special cells that can turn into many different types of cells. For transplant, they can be taken from bone marrow or blood.
HIV – This is the virus that causes AIDS.
Being sick in the hospital for a long time, especially in the intensive care unit (also called the "ICU")
Being born early – Babies who are born early ("premature") are at risk, especially if they are very small.
CMV can be very serious for people with these conditions. It can even be life-threatening.
Babies can also get CMV when they are in their mother's womb. This is called "congenital CMV." Babies with congenital CMV can have serious health problems, such as hearing or vision loss, having a small head and brain, or being smaller than normal.
What are the symptoms of CMV? — Many people who have the virus do not have symptoms. If symptoms happen, they are usually mild in people with healthy immune systems. People with weak immune systems can have more severe symptoms.
The most common symptom of CMV is an illness called "mononucleosis" or "mono." But CMV is not always the cause of mono. Testing is needed to figure out if CMV is the cause.
Common symptoms of mono from CMV include:
Loss of energy
Swollen glands in the neck – This is more common in children than adults.
Less common CMV symptoms can happen in specific parts of the body. These symptoms are more likely to happen in people with weak immune systems. They can include:
Digestive system problems, such as diarrhea and belly pain
Lung problems, such as trouble breathing and dry cough
Problems with the liver, eyes, nervous system, or heart
Will I need tests? — Yes. There are several tests, but you probably will not need all of them. Tests can include:
Tests on a sample of fluid from your lungs or other part of the body
Tests on a sample of tissue from an affected body part
How is CMV treated? — People with healthy immune systems who get sick with CMV do not usually need treatment. They usually feel better in a few days or weeks. Medicines like ibuprofen (sample brand names: Advil, Motrin) can relieve mild symptoms of CMV. If you take these medicines, be sure to follow the directions on the label.
Doctors can treat severe CMV symptoms with medicines, such as ganciclovir (brand name: Cytovene) or valganciclovir (brand name: Valcyte). These are usually only needed for people with CMV who have weak immune systems. For serious infections, the person might need to stay in the hospital and get their medicine by IV. (An IV is a thin tube that goes into a vein.) For mild infections, the medicines can be taken as a pill.
When a person gets an organ or bone marrow transplant, doctors might give a pill, such as valganciclovir or letermovir (brand name: Prevymis), to help prevent CMV.
What if I am pregnant? — Tell your doctor or nurse if you have a fever, sore throat, and body aches. He or she might do a blood test to check for CMV. You might also have the test if you have a condition that weakens your immune system. This is because you can give the CMV infection to your unborn baby.
CMV can cause serious health problems in some newborn babies, so it is important to know if you have it. That way, doctors can look for problems in the baby and treat them if they happen. Problems can include:
Problems with learning and growing
Most people don't know if they have CMV or not. But if you are pregnant or trying to get pregnant, it's a good idea to do things that reduce your chances of getting it, just in case. You can:
Avoid kissing toddlers and children on the mouth.
Avoid sharing eating or drinking utensils, drinks, or food with toddlers or young children.
Wash your hands well after changing diapers or wiping a child's nose or face.
Avoid having sex if your partner is sick with a CMV infection. CMV can be spread by sex.
All topics are updated as new evidence becomes available and our peer review process is complete.
This topic retrieved from UpToDate on: Mar 30, 2020.
Topic 83958 Version 5.0
Release: 28.2.2 - C28.105
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