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| Cytomegalovirus, Causes, Diagnosis, Treatment, Prevention, Complications |
Cytomegalovirus or CMV is a group of herpes viruses that can infect and survive in the human body for a long time. This virus can be transmitted through body fluids, such as saliva, blood, urine, semen, and breast milk.
In healthy people, CMV infection is generally harmless and doesn't cause health problems or causes only mild symptoms that go away on their own. This is because the immune system can still control the viral infection.
However, if CMV attacks people with weakened immune systems, such as people with type 2 diabetes mellitus or HIV, infection with this virus can cause a variety of symptoms and increase the risk of serious complications, such as neurological disorders and pneumonia.
Causes of Cytomegalovirus
Transmission of the CMV virus can occur through direct contact with body fluids, sex, organ transplantation, or blood donation. The CMV virus can also be passed from mother to baby during childbirth or breastfeeding.
Cytomegalovirus is a virus that can survive in the human body for a long time, in an inactive state, and does not cause any symptoms. However, the virus can reactivate at any time, usually when the immune system is weakened.
Cytomegalovirus risk factors
Cytomegalovirus infection can happen to anyone. However, the following factors can increase a person's risk of being infected with cytomegalovirus:
- Work or live with people with cytomegalovirus infection
- Receiving an organ transplant or blood transfusion
- Have a weak immune system, for example due to suffering from HIV/AIDS or having a smoking habit
- Taking medicines that suppress the immune system, such as immunosuppressant drugs
- Frequently changing partners in sexual activity
Symptoms of Cytomegalovirus
Cytomegalovirus infection in healthy adults generally causes no symptoms at all. However, some patients may experience symptoms such as:
- Fever
- Muscle ache
- Fatigue
- skin rash
- Sore throat
- Swollen lymph nodes
- Decreased appetite
- Headache
CMV infection will have more impact on infants or people with weakened immune systems. In the fetus or infant, symptoms of CMV infection can be detected after birth or several years later. Some of the symptoms of CMV infection that can be experienced by newborns are:
- Premature birth with low birth weight
- Small baby head size (microcephaly)
- Yellow skin and eyes (jaundice)
- Enlarged liver and decreased liver function
- Spleen enlargement
- Purple bruises on the skin
- Pneumonia
Meanwhile, symptoms that are usually found months or years later are hearing loss or growth retardation. Sometimes there can also be visual disturbances.
In people with weakened immune systems, CMV infection can affect almost any organ of the body and cause serious conditions, such as:
- Inflammation of the retina (retinitis), which is characterized by impaired vision
- Severe pneumonia, which is characterized by shortness of breath, cough, and chest pain
- Digestive system disorders, including liver, which is characterized by difficulty swallowing, abdominal pain, yellow skin, bloody diarrhea
- Encephalitis, which is characterized by headaches or even weakness in certain body parts
When to go to the doctor
Generally, flu-like symptoms caused by cytomegalovirus will go away on their own within 3 weeks. However, if the symptoms do not improve, you should immediately consult a doctor, so that the virus can be detected and treated before it causes complications.
If you experience the above symptoms, you are also advised to consult a doctor immediately if you are pregnant, undergoing treatment that suppresses the immune system, or suffer from a disease that makes the immune system weak.
Cytomegalovirus diagnosis
To diagnose a cytomegalovirus infection, the doctor will initially ask about symptoms, conditions and medical history, as well as medications or supplements that the patient is currently taking. Next, the doctor will do the physical.
Investigations will be performed if the doctor suspects a CMV infection. Additional tests that can be performed include:
- Antibody testing, usually with a rapid antibody test, to check if the body has specific antibodies that are produced if there is a CMV infection
- Examination of blood samples, to detect the presence of the virus in the body and the amount of the virus
- Biopsy, to find out whether the CMV virus is active in the body
- Eye examination, to detect disorders of the retina, especially in patients whose immune systems are weak
- Radiological examination, to detect changes or abnormalities in the lungs or brain
Especially for pregnant women suspected of being infected with CMV, the doctor will perform additional examinations in the form of:
- Ultrasound of pregnancy, to detect abnormalities in the fetus
- Amniocentesis (examination of amniotic fluid), to detect the presence of the CMV virus if abnormalities are found in the fetus
In the fetus suspected of being infected with CMV, the doctor will conduct an examination 3 weeks after delivery. CMV in newborns can be diagnosed by urine examination.
Please note, tests to confirm the diagnosis of cytomegalovirus infection are often not performed, especially in adults and children with good immune systems. This is because CMV infection in people with strong immunity can clear up on its own without treatment.
Cytomegalovirus Treatment
As previously explained, people with cytomegalovirus infection with a healthy immune system and only mild symptoms do not need treatment.
Treatment is necessary for people with CMV infection with weakened immune systems, severe symptoms, and infants. The doctor will determine the treatment according to the severity and symptoms experienced by the patient.
Drugs that are generally given are antiviral drugs, for example valganciclovir and ganciclovir. This drug does not completely kill the CMV virus. However, these drugs can slow the progression of the virus in the body, which can relieve symptoms and reduce the risk of complications.
Complications of Cytomegalovirus
Complications of cytomegalovirus vary and can be experienced by anyone, depending on the general condition of the patient.
In people with CMV with a weakened immune system, complications that can arise are:
- Blindness, due to inflammation of the retina
- Respiratory failure due to pneumonia
- Malnutrition, due to digestive system disorders
- Swelling of the brain and loss of consciousness, due to encephalitis
Complications are also possible in infants with congenital CMV infection. These complications can include:
- Hearing loss
- Visual disturbance
- Seizure
- Lack of body coordination
- Musculoskeletal disorders
- Decreased intellectual function
In rare cases, cytomegalovirus can also cause complications in otherwise healthy adults. These complications include:
- Mononucleosis
- Digestive system disorders, such as esophagitis and colitis
- Nervous system disorders, such as encephalitis
- Disorders of the heart, such as myocarditis
- Guillain-Barré . syndrome
Cytomegalovirus Prevention
Prevention of cytomegalovirus is very important, especially in pregnant women and people with weakened immune systems. CMV infection can be prevented in the following ways:
- Wash your hands with soap and water for 15-20 seconds, especially before and after coming into contact with small children.
- Avoid direct contact with other people's body fluids, such as by kissing the lips, especially for pregnant women.
- Avoid sharing food or drinks from the same glass or plate with other people.
- Clean tables, chairs, or toys regularly, especially objects that are often touched by children.
- Dispose of waste carefully, especially waste that has been contaminated with bodily fluids, such as diapers and tissues.
- Get a TORCH test when you are planning a pregnancy or when you find out you are pregnant.
- Avoid having risky sexual relationships, such as having multiple sexual partners and not wearing condoms or having sex with people whose sex life history is unknown.
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