Severe cytomegalovirus infection in apparently immunocompetent patients: a systematic review

Rafailidis, Petros I.; Mourtzoukou, Eleni G.; Varbobitis, Ioannis; Falagas, Matthew E.

doi:10.1186/1743-422x-5-47

Cited by 553 publications

(555 citation statements)

References 18 publications

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“…Symptomatic CMV infections are typically manifested as a non-specific febrile disease or a mild self-limiting mononucleosis-like syndrome [4]. However, there are many reports of severe or prolonged symptomatic CMV infection in immunocompetent patients [5][6][7]. After primary infection, CMV establishes a lifelong latent infection that can periodically reactivate [3].…”

Section: Introductionmentioning

confidence: 99%

Seroepidemiology of cytomegalovirus infections in Croatia

Vilibić-Čavlek

Kolarić

Beader

et al. 2016

Wien Klin Wochenschr

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Objectives: Cytomegalovirus (CMV) is endemic worldwide, with marked differences in the seroprevalence rates between countries. The aim of this study was to analyze the seroprevalence of CMV infection in Croatia. Methods:During a three year period (2013)(2014)(2015), 2438 consecutive serum samples collected from Croatian residents were tested for the presence of CMV IgM and IgG antibodies using enzyme-linked immunoassay. IgM/IgG positive samples were further tested for IgG avidity. Results:The overall seroprevalence rates for CMV IgG and IgM antibodies were 74.4% and 4.3%, respectively. The IgG seroprevalence differed significantly between population groups: children/adolescents 54.6%, adult general population 77.2%, hemodialysis patients 91.4% (p<0.001). CMV seropositivity was strongly age-dependent with prevalence ranging from 53.0% in children less than 10 years to 93.8% in persons above 60 years (p<0.001). There was no difference in the prevalence between women with normal pregnancy and women with bad obstetric history. Gender and place of residence was not associated with CMV seropositivity.Using IgG avidity, current/recent primary CMV infection was confirmed by low/borderline avidity index (AI) in 46.7% participants, while in 53.3% high AI indicated CMV reactivation or reinfection. Primary infections were detected mainly in children and adolescents (83.2% and 70.5%), while reactivations/reinfections were common in persons older than 40 (77.0-100%). Reactivations/reinfections were most commonly detected in hemodialysis patients (92.3%). Logistic regression showed that older age and being on hemodialysis were significant predictors of CMV seropositivity.Conclusions: CMV is widespread in the Croatian population. Older age and being on hemodialysis appeared to be main risk factors for CMV infection.

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Section: Introductionmentioning

confidence: 99%

Seroepidemiology of cytomegalovirus infections in Croatia

Vilibić-Čavlek

Kolarić

Beader

et al. 2016

Wien Klin Wochenschr

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“…Cytomegalovirus (CMV), a member of the beta-herpesvirus family, causes an infectious condition which may lead more frequently to morbidity and mortality in immunosuppressed patients (2,3). Contrary to what is commonly believed, it may also lead to serious and lethal infectious conditions in immunocompetent patients (4). It may involve any part of the gastrointestinal system, but it affects more frequently the colon (4,5).…”

mentioning

confidence: 70%

“…Contrary to what is commonly believed, it may also lead to serious and lethal infectious conditions in immunocompetent patients (4). It may involve any part of the gastrointestinal system, but it affects more frequently the colon (4,5). This disease generally starts as an opportunistic infection, hence its onset and severity are very difficult to predict.…”

mentioning

confidence: 96%

Cytomegalovirus ileocolitis in a rheumatoid arthritis patient: case report and literature review

et al. 2015

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Rheumatoid arthritis (RA) is an autoimmune, systemic, chronic, inflammatory disease generally treated with various immunosuppressive drugs. Cytomegalovirus (CMV) is an opportunistic, viral infection that is commonly seen in immunosuppressed patients. A sixty-four-year old female diagnosed with RA and treated with immunosuppressive agents was admitted to our rheumatology outpatient service with complaints of diarrhea and abdominal pain, which had lasted longer than four weeks. The patient’s colonoscopy revealed inflamed and ulcerated areas in the colon and in the terminal ileum. A biopsy showed intra-nuclear inclusion particles consistent with CMV. We started an oral valganciclovir therapy in this serum-CMV-polymerase chain reaction-positive patient. The concomitant use of immunosuppressive agents and anti-viral drugs eased the patient’s complaints, and the endoscopic picture improved. Consequently, cytomegalovirus ileocolitis in immunosuppressed patients admitted with severe diarrhea must be considered in the differential diagnosis.

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“…Тропность вируса ко многим тканям и вовлечение в патологический процесс целого ряда органов и систем определя-ет клиническую симптоматику, совпадающую с клиническими проявлениями критических состо-яний. Наиболее часто при реактивации ЦМВ от-мечается поражение желудочно-кишечного трак-та (гепатит, гастроэнтерит, дуоденит, энтерит, колит, проктит), центральной нервной системы (энцефалит, миелит, энцефаломиелит, менингит и менингоэнцефалорадикулопатия) и крови (ге-молитическая анемия, тромбоцитопения, ДВС, и панцитопения) [34]. Другие органы редко вовле-каются в патологический процесс.…”

Section: цмви у пациентов в критическом состоянииunclassified