Cytomegalovirus infection history and symptoms: Difference between revisions
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==Overview== | ==Overview== | ||
In most patients, primary infection with CMV presents with a [[mononucleosis]] like presentation. Patients with [[immunosuppression]] have symptoms related to the affected organ system. [[Retinitis]] presents with [[blurred vision]] and [[floaters]]. [[Colitis]] presents with [[abdominal pain]] and [[bloody diarrhea]]. [[Pneumonitis]] is usually asymptomatic. Neurologic infection presents with [[altered mental status]] and focal neurological deficits. | |||
==History and Symptoms== | ==History and Symptoms== | ||
Presentation of patients with [[Cytomegalovirus infection|CMV infection]] differs with the organ system involved and is as follows: <ref name="urlwww.idsociety.org">{{cite web |url=https://www.idsociety.org/uploadedFiles/HIVMA/Guidelines_Patient_Care/HIVMA_Standards_Practice_Guidelines/HIV_Guidelines/Guidelines_Content/adult_oi.pdf |title=www.idsociety.org |format= |work= |accessdate=}}</ref><ref name="pmid27252178">{{cite journal| author=Pinninti S, Hough-Telford C, Pati S, Boppana S| title=Cytomegalovirus and Epstein-Barr Virus Infections. | journal=Pediatr Rev | year= 2016 | volume= 37 | issue= 6 | pages= 223-34 | pmid=27252178 | doi=10.1542/pir.2015-0072 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27252178 }} </ref><ref name="pmid10100416">{{cite journal| author=Cheung TW, Teich SA| title=Cytomegalovirus infection in patients with HIV infection. | journal=Mt Sinai J Med | year= 1999 | volume= 66 | issue= 2 | pages= 113-24 | pmid=10100416 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10100416 }} </ref> | |||
===CMV Retintis=== | ===CMV Retintis=== | ||
*Peripheral retinitis can be asymptomatic or present with the following symptoms: | *Peripheral [[retinitis]] can be asymptomatic or present with the following symptoms: | ||
**Floaters | **[[Floaters]] | ||
**Scotomata | **[[Scotoma|Scotomata]] | ||
**Peripheral visual field defects | **Peripheral [[Visual field defect|visual field defects]] | ||
*Central retinal lesions or lesions impinging on the macula or optic nerve are result in decreased visual acuity and central field defects. | *Central retinal lesions or lesions impinging on the [[macula]] or [[optic nerve]] are result in decreased [[visual acuity]] and central field defects. | ||
===CMV Colitis=== | ===CMV Colitis=== | ||
[[Colitis]] presents with the following symptoms: | |||
*Weight loss | *[[Weight loss]] | ||
*Anorexia | *[[Anorexia]] | ||
*Abdominal pain | *[[Abdominal pain]] | ||
*Diarrhea | *[[Diarrhea]] | ||
*Fever | *[[Fever]] | ||
*Malaise | *[[Malaise]] | ||
*Patients with perforation of the bowel present with acute abdominal pain. | *Patients with [[perforation]] of the [[bowel]] present with acute [[abdominal pain]]. | ||
===CMV Esophagitis=== | ===CMV Esophagitis=== | ||
Patients with cytomegalovirus esophagitis present with symptoms of: | Patients with [[cytomegalovirus]] [[esophagitis]] present with symptoms of:<ref name="pmid18627655">{{cite journal| author=Baroco AL, Oldfield EC| title=Gastrointestinal cytomegalovirus disease in the immunocompromised patient. | journal=Curr Gastroenterol Rep | year= 2008 | volume= 10 | issue= 4 | pages= 409-16 | pmid=18627655 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18627655 }} </ref><ref name="pmid8054532">{{cite journal| author=Chui DW, Owen RL| title=AIDS and the gut. | journal=J Gastroenterol Hepatol | year= 1994 | volume= 9 | issue= 3 | pages= 291-303 | pmid=8054532 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8054532 }} </ref> | ||
*Odynophagia | *[[Odynophagia]] | ||
*Nausea | *[[Nausea]] | ||
*Mid-epigastric or retrosternal discomfort | *Mid-epigastric or retrosternal discomfort | ||
*Fever | *[[Fever]] | ||
===CMV Encephalitis=== | ===CMV Encephalitis=== | ||
Patients with [[cytomegalovirus]] [[encephalitis]] presents with:<ref name="pmid2161721">{{cite journal| author=Suzuki Y, Kamei S, Tamura M, Sawai S, Takasu T| title=[Cytomegalovirus encephalitis in immunologically normal adults]. | journal=Rinsho Shinkeigaku | year= 1990 | volume= 30 | issue= 2 | pages= 168-73 | pmid=2161721 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2161721 }} </ref> | |||
*Fever | *[[Fever]] | ||
*Lethargy | *[[Lethargy]] | ||
*Confusion | *[[Confusion]] | ||
*[[Altered mental status]] | |||
===CMV Ventriculoencephalitis=== | ===CMV Ventriculoencephalitis=== | ||
Patients with [[cytomegalovirus]] [[Encephalitis|ventricluloencephalitis]] present:<ref name="pmid2552024">{{cite journal| author=Fuller GN, Guiloff RJ, Scaravilli F, Harcourt-Webster JN| title=Combined HIV-CMV encephalitis presenting with brainstem signs. | journal=J Neurol Neurosurg Psychiatry | year= 1989 | volume= 52 | issue= 8 | pages= 975-9 | pmid=2552024 | doi= | pmc=1031837 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2552024 }} </ref> | |||
* | *Acute onset of symptoms with focal neurological deficits | ||
*Cranial nerve palsies | *[[Cranial nerve]] palsies | ||
*Nystagmus | *[[Nystagmus]] | ||
*Rapid progression to death | *Rapid progression to death | ||
===CMV Polyradiculomyelopathy | |||
Patients with cytomegalovirus polyradiculomyelopathy present with features similar to Guillian Barre Syndrome and have symptoms such as: | ===CMV Polyradiculomyelopathy=== | ||
*Bladder incontinence | Patients with [[cytomegalovirus]] [[Myelopathy|polyradiculomyelopathy]] present with features similar to [[Gullian-Barre syndrome|Guillian Barre Syndrome]] and have symptoms such as:<ref name="pmid8394748">{{cite journal| author=Kim YS, Hollander H| title=Polyradiculopathy due to cytomegalovirus: report of two cases in which improvement occurred after prolonged therapy and review of the literature. | journal=Clin Infect Dis | year= 1993 | volume= 17 | issue= 1 | pages= 32-7 | pmid=8394748 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=8394748 }} </ref> | ||
*Paraplegia with gradual worsening of symptoms over weeks | *[[Bladder incontinence]] | ||
*[[Paraplegia]] with gradual worsening of symptoms over weeks | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
[[Category:Emergency medicine]] | |||
[[Category:Disease]] | |||
[[Category:Up-To-Date]] | |||
[[Category:Infectious disease]] | |||
[[Category:Neurology]] | |||
[[Category:Neurosurgery]] | |||
[[Category:Gastroenterology]] | |||
[[Category:Ophthalmology]] | |||
Latest revision as of 21:13, 29 July 2020
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]
Overview
In most patients, primary infection with CMV presents with a mononucleosis like presentation. Patients with immunosuppression have symptoms related to the affected organ system. Retinitis presents with blurred vision and floaters. Colitis presents with abdominal pain and bloody diarrhea. Pneumonitis is usually asymptomatic. Neurologic infection presents with altered mental status and focal neurological deficits.
History and Symptoms
Presentation of patients with CMV infection differs with the organ system involved and is as follows: [1][2][3]
CMV Retintis
- Peripheral retinitis can be asymptomatic or present with the following symptoms:
- Floaters
- Scotomata
- Peripheral visual field defects
- Central retinal lesions or lesions impinging on the macula or optic nerve are result in decreased visual acuity and central field defects.
CMV Colitis
Colitis presents with the following symptoms:
- Weight loss
- Anorexia
- Abdominal pain
- Diarrhea
- Fever
- Malaise
- Patients with perforation of the bowel present with acute abdominal pain.
CMV Esophagitis
Patients with cytomegalovirus esophagitis present with symptoms of:[4][5]
- Odynophagia
- Nausea
- Mid-epigastric or retrosternal discomfort
- Fever
CMV Encephalitis
Patients with cytomegalovirus encephalitis presents with:[6]
CMV Ventriculoencephalitis
Patients with cytomegalovirus ventricluloencephalitis present:[7]
- Acute onset of symptoms with focal neurological deficits
- Cranial nerve palsies
- Nystagmus
- Rapid progression to death
CMV Polyradiculomyelopathy
Patients with cytomegalovirus polyradiculomyelopathy present with features similar to Guillian Barre Syndrome and have symptoms such as:[8]
- Bladder incontinence
- Paraplegia with gradual worsening of symptoms over weeks
References
- ↑ "www.idsociety.org" (PDF).
- ↑ Pinninti S, Hough-Telford C, Pati S, Boppana S (2016). "Cytomegalovirus and Epstein-Barr Virus Infections". Pediatr Rev. 37 (6): 223–34. doi:10.1542/pir.2015-0072. PMID 27252178.
- ↑ Cheung TW, Teich SA (1999). "Cytomegalovirus infection in patients with HIV infection". Mt Sinai J Med. 66 (2): 113–24. PMID 10100416.
- ↑ Baroco AL, Oldfield EC (2008). "Gastrointestinal cytomegalovirus disease in the immunocompromised patient". Curr Gastroenterol Rep. 10 (4): 409–16. PMID 18627655.
- ↑ Chui DW, Owen RL (1994). "AIDS and the gut". J Gastroenterol Hepatol. 9 (3): 291–303. PMID 8054532.
- ↑ Suzuki Y, Kamei S, Tamura M, Sawai S, Takasu T (1990). "[Cytomegalovirus encephalitis in immunologically normal adults]". Rinsho Shinkeigaku. 30 (2): 168–73. PMID 2161721.
- ↑ Fuller GN, Guiloff RJ, Scaravilli F, Harcourt-Webster JN (1989). "Combined HIV-CMV encephalitis presenting with brainstem signs". J Neurol Neurosurg Psychiatry. 52 (8): 975–9. PMC 1031837. PMID 2552024.
- ↑ Kim YS, Hollander H (1993). "Polyradiculopathy due to cytomegalovirus: report of two cases in which improvement occurred after prolonged therapy and review of the literature". Clin Infect Dis. 17 (1): 32–7. PMID 8394748.