Cytomegalo virus

Question 1

HHV 5

Answer 1

Cytomegalovirus

Question 2

What are the possible transmission routes of cytomegalovirus?

Answer 2

• Horizontal (contact with bodily fluid on infected person incl saliva, blood, semen, urine, breast milk)
• Vertical (in utero, perinatally or postnatally)

*CMV cause congenital CMV infection

Question 3

Where does CMV replication takes place?

*Replication is slow, producing gigantic Cytomegalic cells with intranuclear inclusions

Answer 3

• Salivary glands and kidneys

then Sheds in saliva and urine. (Hence its transmitted through contact with these body fluids)

Question 4

How does CMV perinatal infection take place?

Answer 4

Results from close contact of the neonate with the infected genital secretions of a mother at labor

*x10 more common

Question 5

How does CMV postnatal infection take place?

Answer 5

Occurs after birth, typically through exposure to CMV-infected bodily fluids such as saliva, urine, and breast milk.

*Syndrome of mononucleosis may develop with postnatal CMV infection

Question 6

What are the 3 symptoms commonly observed together in newborns with congenital CMV?

Answer 6

• Chorioretinitis (inflammation of the choroid and retina of the eye. In congenital CMV infection, chorioretinitis can lead to vision impairment or blindness if not treated promptly.
• hydrocephalus- (abnormal accumulation of cerebrospinal fluid within the cavities (ventricles) of the brain.)
• intracranial calcifications

Question 7

The 3 symotoms commonly observed together on newborns with CMV are collectively called_____

Answer 7

‘Classic triad’ of neonate symptoms

Question 8

A disorder characterized by the presence of large intranuclear inclusions (also known as cyclomegaly) in various tissues throughout the body.

*Inclusions are also called owl’s eye

Answer 8

Cyclomegalic Inclusion Disease

*These inclusions are typically found in the brain, eyes, liver, and kidneys, among other organs.

Question 9

The presence of intranuclear inclusion in various body organs has multiple impact. These include: _________

Answer 9

CNS abnormalities – microcephaly, mental retardation, spasticity, epilepsy, periventricular
calcification
- Eye – choroidoretinitis and optic atrophy (degeneration or damage of the optic nerve)
- Ear – sensorineural deafness
- Liver – hepatosplenomegaly and jaundice which is due to hepatitis
- Lung – pneumonitis
- Heart – myocarditis
- Thrombocytopenic purpura, Haemolytic anaemia
- Late sequelae in individuals asymptomatic at birth – hearing defects and reduced intelligence

Question 10

What are possible diagnostic methods for CMV?

Answer 10

Direct detection:
- PCR for CMV DNA
- Biopsy specimens histology (remove piece of tissue from organ suspected to be infected with CMV to assess for histological features suggestive of CMV infection.
-CMV inclusion antibodies or CMV antigens

• CMV Viral load
• Virus isolation (up to 4 weeks for result)
• Rapid culture methods can provide result in 24-48hrs
• Serology
  -IgG-> past infection
  -IgM-> recent primary infection

Question 11

What’s the possible treatment for CMV?

Answer 11

• Ganciclovir,
• Foscarnet and
• Cidofovir are used as anti CMV agents

Question 12

What 2 human herpes viruses are associated with/cause:

1. exanthem subitem (also known as roseola infantum-childhood fever & rash infecting children from ages 6 months to 2 years)
2. Rejection of transplanted kidneys.

Answer 12

HHV 6&7

*Antibodies to this virus are present in almost everyone by age 5.

Question 13

Which HHV is transmitted through saliva and breastmilk,
and Infects T and B lymphocytes?

Answer 13

HHV 6&7

Question 14

What conditions are associated with HHV8?

Answer 14

• Kaposi sarcoma
• Intra-abdominal solid tumors
• Castleman’s disease
• and Primary effusion lymphomas.

Question 15

What’s the clinical manifestation of HHV 8?

Answer 15

Clinically manifests as non-painful dark skin and oral lesions (usually on the palate and gums)