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Cytomegalovirus (CMV) Inclusion Disease

David L. Lee, MD, Munima Nasir, MD and Jarrett Sell, MD, AAHIVS Reviewed 06/2018
 


BASICS

A ubiquitous and common infection impacting people of all ages, ethnic and socioeconomic groups, and geographic areas 
  • Although most cytomegalovirus (CMV) infections are asymptomatic or cause mi...

DIAGNOSIS

HISTORY

  • Congenital

    • ~1% (0.2–2.2%) of newborns are congenitally infected with CMV (3).

    • Most infected newborns appear normal and are asymptomatic, although as many as 7–15% develop sensorineural ...

TREATMENT

MEDICATION

First Line

  • Congenital disease: ganciclovir 6 mg/kg IV q12h for 6 weeks (3)[A], alternately valganciclovir 16 mg/kg PO q12h for 6 weeks if patient is >7 days old and can tolerate ...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

Patient Monitoring

  • CMV urine culture at birth for all HIV-infected or exposed with annual testing in CMV seronegative/HIV+ children

  • Patients with CD4 counts <50 ...

REFERENCES

1
Panel on Opportunistic Infections in HIV-Infected Adults and Adolescents. Guidelines for the prevention and treatment of opportunistic infections in HIV-infected adults and adolescents: re...

ADDITIONAL READING

  • Amir J, Wolf DG, Levy I. Treatment of symptomatic congenital cytomegalovirus infection with intravenous ganciclovir followed by long-term oral valganciclovir. Eur J Pediatr.  2...

CODES

ICD10

  • B25.9 Cytomegaloviral disease, unspecified

  • P35.1 Congenital cytomegalovirus infection

  • B25.8 Other cytomegaloviral diseases

ICD9

  • 078.5 Cytomegaloviral disease

  • 771.1 Congenital cytomegalovirus inf...

CLINICAL PEARLS

  • CMV is a major cause of sensorineural hearing loss in young children.

  • Up to 97% of adults worldwide have antibodies to CMV.

  • CMV mononucleosis syndrome has less cervical adenopathy and/or...

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