CMV in immunocompromised host

Symptoms:

• prolonged fever
• general discomfort, uneasiness, or ill feeling (malaise)
• loss of appetite
• fatigue
• night sweats
• muscle aches or joint pain
• joint stiffness
• weakness
• weight loss

In an immunocompromised individual, CMV can attack specific organs. The major symptoms of these organ-specific infections are listed below.

• eye--major symptoms are:
  • visual impairment
  • blindness
• lungs--major symptoms are:
  • pneumonia with impaired oxygen uptake (hypoxia)
• gastrointestinal--major symptoms are:
  • diarrhea
  • ulcerations with bleeding
• brain--major symptoms are:
  • encephalitis with behavioral changes
  • seizures
  • coma

Signs and tests:

• Blood or urine culture: a blood or urine test that attempts to grow the virus in the laboratory. It can take up to 3 weeks to obtain the result of this test.
• CMV PCR: a blood test that detects the presence of and amount of CMV in the blood.
• CMV antigenemia: a blood test that detects the viral particles on the surface of white blood cells. This can tell you if the virus is actively replicating in the body or simply present in a dormant state.
• CMV serology: a test to detect antibodies in the blood targeted against CMV. These antibodies can be of two types: IgG (old infection) or IgM (new infection). Typically, patients have both of these types of antibodies.
• Tissue biopsy for culture: a biopsy of the tissue (often times - lung or stomach) thought to be infected with CMV is cultured in the laboratory. The tissue can then be examined for evidence of viral infection and presence of CMV viral particles.

Update Date: 04/01/00

Updated By: Luis A. Diaz, Jr. M.D., Johns Hopkins Medical Institute, VeriMed Health Network