Cytomegalovirus (CMV) infection
CMV mononucleosis; Cytomegalovirus; CMV; Human cytomegalovirus; HCMVCytomegalovirus (CMV) infection is a disease caused by a type of herpes virus.
Causes
Infection with CMV is very common. The infection is spread by:
- Blood transfusions
- Organ transplants
- Respiratory droplets
- Saliva
- Sexual contact
- Urine
- Tears
Most people come into contact with CMV in their lifetime. But usually, it's people with a weakened immune system, such as those with HIV/AIDS, who become ill from CMV infection. Some otherwise healthy people with CMV infection develop a mononucleosis-like syndrome.
CMV is a type of herpes virus. All herpes viruses remain in your body for the rest of your life after infection. If your immune system becomes weakened in the future, this virus may have the chance to reactivate, causing symptoms.
Symptoms
Many people are exposed to CMV early in life, but do not realize it because they have no symptoms, or they have mild symptoms that resemble the common cold or flu. These may include:
- Enlarged lymph nodes, especially in the neck
- Fever
Fever
Fever is the temporary increase in the body's temperature in response to a disease or illness. A child has a fever when the temperature is at or abov...
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Fatigue
Fatigue is a feeling of weariness, tiredness, or lack of energy.
Read Article Now Book Mark Article - Loss of appetite
Loss of appetite
A decreased appetite is when your desire to eat is reduced. The medical term for a loss of appetite is anorexia.
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Malaise
Malaise is a general feeling of discomfort, illness, or lack of well-being.
Read Article Now Book Mark Article - Muscle aches
Muscle aches
Muscle aches and pains are common and can involve more than one muscle. Muscle pain also can involve ligaments, tendons, and fascia. Fascias are th...
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- Sore throat
CMV can cause infections in different parts of the body. Symptoms vary depending on the area that is affected. Examples of body areas that can be infected by CMV are:
- The lungs
Lungs
Cytomegalovirus (CMV) pneumonia is a viral infection of the lungs that can occur in people who have a suppressed immune system.
Read Article Now Book Mark Article - The stomach or intestine
Stomach or intestine
CMV gastroenteritis/colitis is inflammation of the stomach or intestine due to infection with cytomegalovirus. This same virus can also cause:Lung in...
Read Article Now Book Mark Article - The back of the eye (retina)
Retina
Cytomegalovirus (CMV) retinitis is a viral infection of the retina of the eye resulting in inflammation.
Read Article Now Book Mark Article - A baby while still in the womb (congenital CMV)
Congenital CMV
Congenital cytomegalovirus is a condition that can occur when an infant is infected with a virus called cytomegalovirus (CMV) before birth. Congenit...
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Exams and Tests
Your health care provider will perform a physical exam and feel your belly area. Your liver or spleen may be enlarged or tender when they are gently pressed (palpated). You may have a skin rash.
Special lab tests such as a CMV DNA serum PCR test may be done to check for presence of substances in your blood produced by CMV. Tests, such as a CMV antibody test, may be done to check the body's immune response to the CMV infection.
CMV DNA serum PCR test
The CMV blood test determines the presence of substances (proteins) called antibodies to a virus called cytomegalovirus (CMV) in the blood.
Read Article Now Book Mark ArticleOther tests may include:
- Blood tests for platelets and white blood cells
Platelets
A platelet count is a lab test to measure how many platelets you have in your blood. Platelets are particles in the blood that help the blood clot. ...
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Chemistry panel
A comprehensive metabolic panel is a group of blood tests. They provide an overall picture of your body's chemical balance and metabolism. Metaboli...
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Liver function tests
Liver function tests are common tests that are used to see how well the liver is working. Tests include:AlbuminAlpha-1 antitrypsinAlkaline phosphata...
Read Article Now Book Mark Article - Mono spot test (to distinguish from mononucleosis due to Epstein-Barr virus infection)
Mono spot test
The mononucleosis spot test looks for 2 antibodies in the blood. These antibodies appear during or after an infection with the virus that causes mon...
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Treatment
Most people recover in 4 to 6 weeks without medicine. Rest is needed, sometimes for a month or longer to regain full activity levels. Painkillers and warm salt-water gargles can help relieve symptoms.
Antiviral medicines and antibody therapy are usually not used in people with healthy immune function, but may be used for people with an impaired immune system.
Outlook (Prognosis)
Outcome is good with treatment. The symptoms may be relieved in a few weeks to months.
Possible Complications
Throat infection is the most common complication. Rare complications include:
- Colitis
Colitis
Colitis is swelling (inflammation) of the large intestine (colon).
Read Article Now Book Mark Article - Guillain-Barré syndrome
Guillain-Barré syndrome
Guillain-Barré syndrome (GBS) is a serious health problem that occurs when the body's defense (immune) system mistakenly attacks part of the peripher...
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- Pericarditis or myocarditis
Pericarditis
Pericarditis is a condition in which the sac-like covering around the heart (pericardium) becomes inflamed.
Read Article Now Book Mark ArticleMyocarditis
Myocarditis is inflammation of the heart muscle. The condition is called pediatric myocarditis when it occurs in children.
Read Article Now Book Mark Article - Pneumonia
Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
Read Article Now Book Mark Article - Rupture of the spleen
- Inflammation of liver (hepatitis)
When to Contact a Medical Professional
Contact your provider for an appointment if you have symptoms of CMV infection.
Go to the emergency room or call 911 or the local emergency number if you have sharp, severe sudden pain in your left upper abdomen. This could be a sign of a ruptured spleen, which may require emergency surgery.
Prevention
CMV infection can be contagious if the infected person comes in close or intimate contact with another person. You should avoid kissing and sexual contact with an infected person.
The virus may also spread among young children in day care settings.
When planning blood transfusions or organ transplants, the CMV status of the donor can be checked to avoid passing CMV to a recipient who has not had CMV infection.
References
Britt WJ. Cytomegalovirus. In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 137.
Centers for Disease Control and Prevention website. Cytomegalovirus (CMV) and congenital CMV infection. Clinical overview of CMV and congenital CMV. www.cdc.gov/cytomegalovirus/hcp/clinical-overview/. Updated April 5, 2024. Accessed June 17, 2024.
Drew WL, Boivin G. Cytomegalovirus. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 26th ed. Philadelphia, PA: Elsevier; 2020:chap 352.
Mononucleosis - photomicrograph of cells - illustration
This so-called Downy cell is typical of lymphocytes infected by EBV (Epstein Barr Virus) or CMV (Cytomegalovirus) in infectious mononucleosis. Downy cells may be classified as types I, II, or III. This is a type II Downy cell.
Mononucleosis - photomicrograph of cells
illustration
Mononucleosis - photomicrograph of cells - illustration
This is a lymphocyte that has been infected by the Epstein-Barr Virus (EBV) or Cytomegalovirus (CMV) in infectious mononucleosis and is referred to as a Downy cell. Downy cells may be classified as types I, II, or III. this is a type I Downy cell.
Mononucleosis - photomicrograph of cells
illustration
Infectious mononucleosis #3 - illustration
Infectious mononucleosis is caused by the Epstein-Barr virus. It is a viral infection causing high temperature, sore throat, and swollen lymph glands. Infectious mononucleosis can be contagious if the infected person comes in close or intimate contact with another person through saliva or sexual contact.
Infectious mononucleosis #3
illustration
Mononucleosis infecciosa - illustration
Swollen lymph nodes, sore throat, fatigue and headache are some of the symptoms of mononucleosis, which is caused by the Epstein-Barr virus. It is generally self-limiting and most patients can recover in 4 to 6 weeks without medicines.
Mononucleosis infecciosa
illustration
Mononucleosis - photomicrograph of cell - illustration
This picture shows large, atypical lymphocytes (white blood cells). These cells are seen in viral infections, most commonly caused by the Epstein-Barr virus (infectious mononucleosis), cytomegalovirus diseases, and occasionally infectious hepatitis. This is an example of a type I Downy cell.
Mononucleosis - photomicrograph of cell
illustration
Mononucleosis - mouth - illustration
Infectious mononucleosis is caused by the Epstein-Barr virus. In teenagers and young adults, there is frequently a sore throat and red tonsils with whitish spots (exudate), as seen in this picture. Enlarged lymph nodes and fatigue are also common.
Mononucleosis - mouth
illustration
Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
Mononucleosis - photomicrograph of cells - illustration
This so-called Downy cell is typical of lymphocytes infected by EBV (Epstein Barr Virus) or CMV (Cytomegalovirus) in infectious mononucleosis. Downy cells may be classified as types I, II, or III. This is a type II Downy cell.
Mononucleosis - photomicrograph of cells
illustration
Mononucleosis - photomicrograph of cells - illustration
This is a lymphocyte that has been infected by the Epstein-Barr Virus (EBV) or Cytomegalovirus (CMV) in infectious mononucleosis and is referred to as a Downy cell. Downy cells may be classified as types I, II, or III. this is a type I Downy cell.
Mononucleosis - photomicrograph of cells
illustration
Infectious mononucleosis #3 - illustration
Infectious mononucleosis is caused by the Epstein-Barr virus. It is a viral infection causing high temperature, sore throat, and swollen lymph glands. Infectious mononucleosis can be contagious if the infected person comes in close or intimate contact with another person through saliva or sexual contact.
Infectious mononucleosis #3
illustration
Mononucleosis infecciosa - illustration
Swollen lymph nodes, sore throat, fatigue and headache are some of the symptoms of mononucleosis, which is caused by the Epstein-Barr virus. It is generally self-limiting and most patients can recover in 4 to 6 weeks without medicines.
Mononucleosis infecciosa
illustration
Mononucleosis - photomicrograph of cell - illustration
This picture shows large, atypical lymphocytes (white blood cells). These cells are seen in viral infections, most commonly caused by the Epstein-Barr virus (infectious mononucleosis), cytomegalovirus diseases, and occasionally infectious hepatitis. This is an example of a type I Downy cell.
Mononucleosis - photomicrograph of cell
illustration
Mononucleosis - mouth - illustration
Infectious mononucleosis is caused by the Epstein-Barr virus. In teenagers and young adults, there is frequently a sore throat and red tonsils with whitish spots (exudate), as seen in this picture. Enlarged lymph nodes and fatigue are also common.
Mononucleosis - mouth
illustration
Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
Review Date: 9/10/2022
Reviewed By: Jatin M. Vyas, MD, PhD, Associate Professor in Medicine, Harvard Medical School; Associate in Medicine, Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Boston, MA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.