- Member of human herpesvirus beta subfamily w/ envelope & dsDNA; viral DNA polymerase is target for drugs. Latency established after infection. Transmission via saliva, blood, genital secretions, breast milk, urine, or feces. Reactivation (increasing w/ advancing immune suppression) responsible for most HIV-related disease.
- CMV retinitis: Full-thickness necrotizing retinitis, most common manifestation of CMV in pts w/ AIDS.
- CMV, gastrointestinal: EGD w/ Bx for esophagitis; colonoscopy with Bx for colonic disease; Dx defined by clinical Sx, macroscopic mucosal lesions on endoscopy, and CMV by Cx, histopathology, immunohistochemical analysis, or in situ hybridization. Histology reveals large basophilic intranuclear "owl’s eye" and intracytoplasmic inclusion bodies.
- CMV, neurologic: CSF WNL for encephalitis, but in polyradiculomyelitis often w/ PMNs, mildly increased protein levels & low glucose. Most sensitive is PCR of CSF for CMV; Cx usually +; MRI may show characteristic periventricular white matter changes (encephalitis).
- CMV pneumonitis: Uncommon condition. Positive Cx from BAL does not establish Dx. Both clinical Sx (see below) & Bx results demonstrating viral inclusions must be used together for Dx.
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