Cytomegalovirus virus is infected. Current methods of treating cytomegalovirus infection

Cytomegalovirus infection (CMVI, or cytomegaly) is a chronic anthroponotic viral disease, which is characterized by a variety of forms of the pathological process from latent infection to clinically significant generalization. called illness.

Cody on MKL-10
B25. Cytomegalovirus disease.
B27.1. Cytomegalovirus mononucleosis.
R35.1. Congenital cytomegalovirus infection.
B20.2. Illness caused by HIV infection due to manifestations of cytomegalovirus disease.

Etiology (causes) of cytomegalovirus infection

In the classification of viruses, the CMV virus under the species name Cytomegalovirus hominis is included in the family Herpesviridae, genus Betaherpesviridae, and genus Cytomegalovirus.

Features of CMV:

Great DNA gene;
- low cytopathogenicity in cell culture;
- Complete replication;
- Low virulence.

The virus is inactivated at a temperature of 56 °C, stored for three hours at room temperature, and quickly inactivated when frozen to –20 °C. CMV is weakly sensitive to interferon and not sensitive to antibiotics. There are 3 virus cases registered: AD 169, Davis and Kerr.

Epidemiology of cytomegalovirus infection

Cytomegaly – widespread infection. The proportion of seropositive individuals among the adult population of the Russian Federation reaches 73-98%. Indicator of CMV illness in the country, 2003. becoming 0.79 per 100,000 population, and in children up to age 1 - 11.58; 1-2 rocks – 1.01; 3–6 years - 0.44 per 100,000. In Moscow, 2006. the incidence rate of CMV infection has increased to 0.59 per 100,000 population, in children up to age 14 it is 3.24; The average adult population is 0.24 per 100,000 people.

Dzherelo budnik infection- people. Cytomegalovirus infection is characterized by the development of latent virus infection, which is periodically seen in the middle part of the body. The virus can be found in any biological environment, as well as in organs and tissues that are being harvested for transplantation. In 20-30% of healthy vaginal women, cytomegalovirus is present in the mule, 3-10% in the muzzle, 5-20% in the cervical canal or vaginal secretion. The virus is detected in the breast milk of 20-60% of seropositive mothers. About 30% of homosexual men and 15% of men who are friends carry the virus in their sperm. About 1% of donors are infected with CMV.

Paths are infected. Infection is possible with state, parenteral, vertical, and also contact-casual pathogens, which is ensured by the aerosol mechanism of transmission of the pathogen through the skin during close contacts.

Cytomegalovirus infection is a classic congenital infection, the frequency of which is 0.3–3% of all newborns. The risk of antenatal infection of the fetus with primary CMV infection in vaginas is 30-40%. When the virus is reactivated, which occurs in 2–20% of mothers, the risk of infection of the child is significantly lower (0.2–2% of cases). Intranatal infection of the child due to the presence of CMV in the genital tract in pregnant women occurs in 50–57% of cases. The main way of infecting a child with HIV is transmission of the virus through breast milk.

Children of seropositive mothers, children who have been breastfed for at least a month, become infected in 40–76% of cases. Also, up to 3% of all newborns are infected with CMV during intrauterine development, 4–5% - intranatally; Before the first fate of life, the number of infected children becomes 10–60%. Contact-based transmission of the virus in children and young adults plays a vital role. Infection with cytomegalovirus infection in children, such as pre-school children, is reliable (80% of cases), less than “home” convalescents of the same century (20%). The number of sero-positive individuals increases with age. Approximately 40–80% of children and 60–100% of the adult population have antibodies of the IgG class to CMV. Infection of adult humans with CMV is most virulent by state, as well as during blood transfusions and parenteral manipulations. Transfusion of whole blood and components to replace leukocytes leading to transmission of the virus at a rate of 0.14–10 per 100 doses.

There is a great risk of developing severe illness during repeated blood transfusions from seropositive donors to newborns, especially premature infants.

Clinically manifested CMV is one of the most common and most serious infectious complications during organ transplantation. Approximately 75% of recipients show laboratory signs of active cytomegalovirus infection in the first 3 months after transplantation.

In 5-25% of patients who have undergone a liver or liver transplant, 20-50% of patients after allogeneic cerebrovascular transplantation, 55-75% of recipients of lung and/or heart disease develop CMV etiology, cytome halovirus infection significantly increases the risk of rejection. Manifest infection occupies one of the first places in the structure of opportunistic illnesses in HIV-infected patients and is avoided in 20–40% of patients on SNID, so as not to discontinue HAART, but in 3–7% of patients, HIV infection is detected when indicated. The development of an important cytomegalovirus infection has been described in oncohematological patients, patients who have suffered from Pneumocystis pneumonia, tuberculosis, metabolic disease, opiate trauma, and in individuals who have been on trivalium corticosterone. Daily therapy for those who have suffered from various stresses. Cytomegalovirus can be the cause of post-transfusion and chronic hepatitis, various gynecological pathologies. The role of cytomegalovirus is transferred as one of the cofactors in the development of systemic vasculitis, atherosclerosis, chronic dissemination of the lungs, cryoglobulinemia, swelling processes, atherosclerosis, cerebral palsy, epilepsy ї, Guillain-Barré syndrome, syndrome. Seasonality, outbreaks and epidemics are not typical for illness associated with cytomegalovirus infection.

Pathogenesis of cytomegalovirus infection

The key factor for the development of antenatal CMV infection is maternal age. The presence of the virus in the blood leads to infection of the placenta, the severity and infection of the fetus with possible consequences in the form of obstruction of intrauterine development, a pathological process affecting the internal organs, first centrally ї nervous system. Due to the presence of a virus in the cervical canal of a vaginal woman, there is a possibility of contagious (transcervical) infection of the fetus without leaving the home. Reactivation of cytomegalovirus in the endometrium is one of the factors of early abortions. Intranatal infection with the virus occurs when the fetus passes through infected birth passages through aspiration of amniotic fluid to remove cytomegalovirus, and/or secretions from birth passages, or through damage to the skin. curves and can also lead to the development of clinically severe illness. In case of postnatal cytomegalovirus infection, the mucous membrane of the oropharynx, respiratory system, herbal and genital tracts serve as the entrance gates for the excitatory system. After the virus infects the entrance gates and its local reproduction, a short period of time ensues, monocytes and lymphocytes carry the virus to various organs. Regardless of the cellular or humoral pathway, cytomegalovirus induces a chronic latent infection.

The reservoir of viral particles is monocytes, lymphocytes, endothelial and epithelial cells. Further, with minor immunosuppression, there is a possibility of “local” activation of CMV from the virus seen in the nasopharynx or urogenital tract. In the glyboid izhmunologa deformation, when the spades, the shit of the pathology, the rejection of the actively replicas, the Vremynatsya Zbudnik, the rods of the Klinno vijazniy Zakhvorivannya, are. The activity of viral replication, the risk of manifestation of cytomegalovirus infection, the severity of the infection are largely determined by the extent of immunosuppression, immediately before the level of decreased blood counts. and CD4 lymphocytes in the blood.

CMV infection involves a wide range of organ systems: lungs, grass tract, supra-neural veins, cervix, brain and spinal cord, eye retina. In immunosuppressed patients with CMV, posthumous fibroatelectasis of the leg is detected, sometimes with cysts and encapsulated abscesses; erosive-virazkova with severe fibrosis of the submucosal ball of the duct, colon, lower intestine and small intestine; massive, often bilateral necrosis of the supranervical veins; encephaloventriculitis, necrotizing spinal cord, eye strain with the development of necrotizing retinitis. The specificity of the morphological picture in CMV infection is indicated by large cytomegal cells, lymphohistiocytic infiltrates, as well as productive-infiltrative panvasculitis with cytomegalic transformations of the tissues of the dry walls, etc. Both arteries and veins have a history of sclerosis. This type of blood vessel formation serves as the basis for thrombus formation, which leads to chronic ischemia, which develops destructive changes, segmental necrosis and abrasions, and fibrosis. Expanded fibrosis is a characteristic feature of CMV infection in an organ. In most patients, the pathological process associated with CMV may be generalized in nature.

Clinical picture (symptoms) of cytomegalovirus infection

The incubation period for infected CMV is 2-12 years.

Classification

There is no generally accepted classification of CMV. The complete classification of illness is complete.

Prirodzhena TsMVI:
- Asymptomatic form;
- manifest form (cytomegalovirus disease).
Pridbana TsMVI.
- Gostra TsMVI.
- Asymptomatic form;
– cytomegalovirus mononucleosis;
- latent CMV.
- CMVI is active (reactivation, reinfection):
- Asymptomatic form;
- CMV-association syndrome;
- Manifest form (cytomegalovirus disease).

The main symptoms of cytomegalovirus infection

When congenital with CMV, the nature of the fetal expression depends on the term of infection. Gostra cytomagalia in the mother in the first 20 years of gestation can lead to an important pathology of the fetus, which results in short term pregnancy, intrauterine fetal death, death, vadi, in most cases, nonsense. z life. When infected with cytomegalovirus in late pregnancy, the prognosis for the life and development of the child is more favorable.

The pathology is clinically pronounced in the first life and occurs in 10-15% of CMV-infected newborns. The manifest form of congenital cytomegalovirus infection is characterized by hepatosplenomegaly, persistent hepatitis, hemorrhagic or plamysto-papular viscera, thrombocytopenia, increased activity of ALT and level of direct b Elirubin in the blood, leading to hemolysis.

Children are often described as premature, with a deficiency of body mass, and signs of intrauterine hypoxia. Characteristic pathology of the central nervous system is microcephaly, sometimes hydrocephalus, encephaloventriculitis, vessel syndrome, and hearing loss. Cytomegalovirus infection is the main cause of congenital deafness. Possible enterocolitis, fibrosis of the sublingual phallus, interstitial nephritis, chronic sialadenitis with fibrosis of the phallus, interstitial pneumonia, atrophy of the visual nerve, congenital cataract, and also generalized lesions in organs with the development of shock, D. Risk of lethal outcome in the first 6 years of life of newborns from clinically manifested CMVI becomes 12%. Nearly 90% of children who lived and suffered from manifest CMV infection may have a long-term history of illness, decreased visual development, sensorineural deafness or bilateral hearing loss, impaired language comprehension with impaired hearing , vessel syndrome, paresis, decreased vision.

In case of intrauterine infection with cytomegalovirus, there may be an asymptomatic form of infection with a low level of activity, if the virus is present in the bird or mucus, and a high level of activity, if the virus is detected in the blood. In 8–15% of cases, there is antenatal CMV infection, which is not manifested by clear clinical symptoms, leading to the development of late complications in appearance, loss of hearing, decreased vision, vascular disorders, obstruction of physical and mental development. A risk factor for the development of illness with central nervous system disorders is the persistent presence of CMV DNA in whole blood during the period of childhood up to 3 months of life. Children with congenital CMV are guilty of being under medical supervision for 3-5 years, some hearing loss can progress in the early stages of life, and clinically significant impairments can be preserved even after 5 years. people

In the absence of severe factors, intranatal or early postnatal CMV is asymptomatic, manifesting clinically in only 2–10% of cases, more often in the form of pneumonia. In premature, weakened children with low fertility, infected with cytomegalovirus before bedtime or in the first days of life through blood transfusion, even up to the 3-5th year of life, a generalized illness develops, the manifestations of which are pneumonia, prolonged pregnancy disease, hepatosphysia, anemia, thrombocytopenia. The illness is of a trivially relapsing nature.

The maximum mortality rate for CMV infection occurs between 2 and 4 months.

The clinical picture of full-blown cytomegalovirus infection in older and adult children depends on the form of infection (primary infection, reinfection, reactivation of the latent virus), modes of infection, evidence stage of severity of immunosuppression. The primary infection of immunocompetent individuals with cytomegalovirus is asymptomatic and in less than 5% of cases there appears to be a mononucleosis-like syndrome, the noticeable signs of which are high fever, expressions and trival asthenic ny syndrome, in the blood – lymphocytosis, atypical. Angina and enlargement of lymphatic nodes are not typical. Infection with the virus through blood transfusion or during transplantation of an infected organ can lead to the development of an acute form of illness, which includes high fever, asthenia, sore throat, lymphadenopathy, myalgia, arthralgia , neutropenia, thrombocytopenia, non-interstitial, interstitial. Due to the presence of immunological disorders, CMV infection becomes latent due to the continued presence of the virus in humans. The development of immunosuppression leads to the renewal of CMV replication, the appearance of the virus in the blood and the possible manifestation of illness. Reintroduction of the virus into the human body by aphid immunodeficient patients may also cause the development of clinically significant CMV infection. With reinfection, the manifestation of CMV occurs more often and occurs more rapidly than when the virus is reactivated.

For CMV in immunosuppressed individuals, illness is characteristic over several long developments, the appearance of warning symptoms such as nausea, fatigue, weakness, loss of appetite, significant decrease in vagina, trivial fever-like fever of the wrong type with body temperature rises above 38.5 ° C, sometimes with sweating at night, arthralgia and myalgia.

This set of symptoms is called “CMV-association syndrome.”

In young children, illness can occur without severe ear toxicosis due to normal or low-grade fever.

CMV infections cause a wide range of organ lesions, with legenia being one of the first to suffer. There is a dry or unproductive cough that gradually gets worse, the throat is dead, and the symptoms of intoxication increase. X-ray signs of legen's pathology may be daily, but during the period of illness, the aphids of a deformed, strengthened legen's baby often show bilateral friable and infiltrative shadows, dissolved And it is important in the middle and lower sections of the leg. If the diagnosis is not made in time, there is a possible development of DN, RDS and death. The stage of lung severity in patients with CMV varies from minimally expressed interstitial pneumonia to extensive fibrous bronchiolitis and alveolitis with forms of bilateral polysegmental fibrosis of the lungs.

Often the virus infects the grass tract. Cytomegalovirus is the main etiological factor of viral defects in the grass tract in patients with HIV infection. The likes of the CMV-Ezofagita to Vistal the Likhoman, the loading of the bil during the passage of the grunts, the ethnicity of the gaping therapy, the non-unhealthy rounds of the virazovs of the same/abdil Stravodil. The lesion of the vulva is characterized by the presence of acute and acute manifestations. The clinical picture of CMV colitis or enterocolitis includes diarrhea, persistent abdominal pain, tenderness of the colon on palpation, decreased body weight, severe weakness, and elevated temperature. Colonoscopy reveals erosions and lesions of the intestinal mucosa. Hepatitis is one of the main clinical forms of CMV in transplacentally infected children in recipients after liver transplantation, patients infected with the virus during blood transfusions. Peculiarity of liver damage in CMV infection - part of the development before the pathological process of chewing paths. CMV hepatitis is characterized by mild clinical progression, but with the development of sclerosing cholangitis, pain in the upper abdomen, fatigue, diarrhea, liver weakness, increased activity of LF and GGTT, and possible cholestasis occur.

The liver lesion is of the nature of granulomatous hepatitis, in some cases it can lead to fibrosis and liver cirrhosis. The pathology of the subglottis in patients with CMV infection is usually asymptomatic or has a blurred clinical picture with an increased concentration of amylase in the blood. High sensitivity to CMV may occur in the cells of the epithelium of the various ducts of the lymphatic veins, which are especially common. Specific changes in older adults with CMV infection in children become more pronounced in the majority of cases. For adult patients with CMV, sialadenitis is not typical.

Cytomegalovirus is one of the causes of the pathology of supra-neural insufficiency (often in patients with HIV infection) and the development of secondary supra-neural insufficiency, which manifests itself as persistent hypotension, weakness, weight loss, anorexia, impaired functioning and intestines, a series of mental illnesses, and, more recently, hyperpigmentation of the skin and mucous membranes. The detection of sick CMV DNA in the blood, as well as persistent hypotension, asthenia, anorexia, will require a significant level of potassium, sodium and chloride in the blood, hormonal studies to analyze the functional activity Hundreds of over-the-holes. CMV-adrenalitis is characterized by cob-like symptoms of the measles with the transition of the process to deep measles, and then to all balls of the measles.

Manifest CMV often occurs with nervous system disorders such as encephaloventriculitis, myelitis, polyradiculopathy, polyneuropathy of the lower ends. CMV encephalitis in patients with IL infection is characterized by poor neurological symptoms (persistent headaches, confusion, horizontal nystagmus, paresis of the spinal nerve, neuropathy of the facial nerve), and changes in mental status (special changes, severe memory loss, intellectual activity, sharp weakening of mental and auditory activity, impaired orientation in the place of time, anosognosia, decreased control over the function of the pelvic organs). Mental-intellectual changes often reach the stage of dementia. Children who have suffered from CMV encephalitis also show increased mental and mental development.

Investigations of the spinal cerebrospinal fluid (SMR) show increased protein density, the presence of an inflamed reaction or mononuclear pleocytosis, normal levels of glucose and chloride. The clinical picture of polyneuropathy and polyradiculopathy is characterized by pain syndrome in the distal parts of the lower ends, sometimes in the lower part of the lower limbs, parasthesia, hyperesthesia It is, causalgia, hyperpathia. With polyradiculopathy, there may be a slight paresis of the lower ends of the legs, which is accompanied by a decrease in pain and tactile sensitivity in the distal parts of the legs. In SMR patients, polyradiculopathy is revealed by protein displacements and lymphocytic pleocytosis.

Cytomegalovirus plays a leading role in the development of myelitis in HIV-infected patients. The lesion of the spinal cord is diffuse in nature and is a late manifestation of CMV infection. At the onset of illness there is a clinical picture of polyneuropathy or polyradiculopathy, then, presumably to an important level of damage to the spinal cord, spastic tetraplegia or spastic paresis of the lower ends develops, The iramid signs, meaning a decrease in all types of sensitivity, are first in the distal parts of the legs; trophic disorders. All diseases suffer from a gross disorder of the function of the pelvic organs, mainly of the central type. In SMR, there is a slight displacement of the protein, lymphocytic pleocytosis.

CMV retinitis is the most common reason for patients wasting time on HIV infection. This pathology has also been described in organ recipients, children with congenital CMV, and in single cases - in pregnant women. Illnesses appear on floating spots, splashes, a veil before the eyes, decreased sharpness and defects in the fields of vision. When ophthalmoscopy on the retina along the periphery of the fundus reveals the middle of a white color with hemorrhages under the hour of the retinal vessels. The progression of the process leads to the formation of a diffuse large infiltrate from areas of retinal atrophy and areas of hemorrhage on the surface of the lesion. The renal pathology of one eye after 2-4 months becomes bilateral in nature and the presence of etiotropic therapy leads to most episodes until the eye is lost. In patients with HIV infection who have a history of CMV retinitis, on aphids HAART, a possible development of the disease may develop as a manifestation of the immune system reactivation syndrome.

Sensory-neural deafness occurs in 60% of children with clinically severe congenital CMV infection. Hearing loss is also possible in adult HIV-infected individuals with manifest CMV. Hearing defects associated with CMV are based on inflammation and ischemic damage to the auditory nerve.

Low evidence demonstrates the role of CMV as an etiological factor in the pathology of the heart (myocarditis, dilated cardiopathy), spleen, lymph nodes, cervix, cerebrospinal fluid with the development of pancytopenia. Interstitial nephritis, called CMV, usually proceeds without clinical manifestations. Possible microproteinuria, microhematuria, leukocyturia, rarely secondary nephrotic syndrome and nitric deficiency. In patients with CMV infection, thrombocytopenia, sometimes severe anemia, leukopenia, lymphopenia and monocytosis are often recorded.

Diagnosis of cytomegalovirus infection

The clinical diagnosis of CMV disease requires obligatory laboratory confirmation.

Testing the patient's blood for the presence of specific antibodies of the IgM class and/or antibodies of the IgG class is not sufficient to establish the fact of active CMV replication, nor to confirm the manifest form of illness. The presence of anti-CMV IgG in the blood further indicates the presence of the virus.

Newborn IgG antibodies are recovered from the mother, and are not evidence of CMV infection. High levels of IgG antibodies in the blood do not correlate with the presence of illness, with an active asymptomatic form of infection, or with the risk of intrauterine infection of the child. The increase in 4 or more times the amount of anti-CMV IgG in “paired orphans” when fasted at an interval of 14–21 days may have a higher diagnostic value.

The presence of anti-CMV IgG in patients with the presence of specific IgM antibodies indicates the presence of CMV infection. The detection of anti-CMV IgM in children in early life is an important criterion for intrauterine infection with the virus; if there is a serious lack of IgM antibodies, they often serve when an active infectious process is detected and There are often hypopositive results. The presence of acute CMV infection is confirmed by neutralizing IgM antibodies present in the blood for no more than 60 days before the time of infection with the virus. The avidity index of anti-CMV IgG, which characterizes the fluidity and intensity of the binding of antigen to antibody, has significant diagnostic and prognostic value. The detection of a low antibody avidity index (less than 0.2 or less than 30%) confirms recent (over 3 months) initial infection with the virus. The presence of low-visibility antibodies in the vagina is a marker of a high risk of transplantental transmission of the pathogen to the fetus. At the same time, the presence of low-visibility antibodies does not completely exclude recent infection.

A virological method, based on the detection of CMV from biological sources in cell culture, is a specific, but laborious, difficult, expensive and insensitive method for diagnosing CMV.

In practical health protection, a simple cultural method for detecting viral antigen in biological materials is used by analyzing infected cells in culture. The detection of early and latent CMV antigens shows the presence of active virus in patients.

However, methods for detecting antigens sacrifice the sensitivity of molecular methods based on PLR, which makes it possible to directly detect CMV DNA in biological materials and tissues in the short term. The clinical significance of DNA and CMV antigen in various biological countries is however not clear.

The presence of the alarm in the rabbit acts as a marker of infection and indicates the current viral activity. The presence of DNA or CMV antigen in a person confirms the fact of infection and active viral activity, which may be significant, especially in the early stages of life. The most important diagnostic value is the detection of DNA or antigen of the virus in whole blood, which confirms the highly active replication of the virus and its etiological role in obvious organ pathology. The detection of CMV DNA in the blood of a pregnant woman is the main marker of a high risk of fetal infection and development of congenital CMV. The fact of fetal infection is confirmed by the detection of CMV DNA in the amniotic region or umbilical cord blood, and after the birth of the child, the DNA of the virus is confirmed in any biological region in the first 2 years of life. Manifest CMV in children in the first months of life is determined by the presence of CMV DNA in the blood; in immunosuppressed individuals (organ recipients who are sick with HIV infection), it is necessary to insert a splint There is DNA of the virus in the blood. Reliably indicating the cytomegalovirus nature of the disease, instead of CMV DNA in whole blood, it is more than 3.0 or more than log10 in 105 leukocytes. The high level of CMV DNA in the blood has great prognostic significance. The appearance and subsequent shift of CMV DNA in whole blood significantly precedes the development of clinical symptoms. The detection of cytomegalocells in histological examination of biopsy and autopsy materials confirms the cytomegalovirus nature of the organ pathology.

Diagnostic standard

Obstruction of vaginal wives to establish the presence of active CMV infection and the risk of vertical transmission of the virus to the fetus.

The value of anti-CMV IgG concentration in blood ranges from 14 to 21 dB.
Testing of amniotic blood and umbilical cord blood for the presence of CMV DNA (as indicated).

Testing of blood and samples for the presence of DNA or virus antigen is planned to be carried out at least twice per hour of pregnancy or for clinical indications.

Testing of newborns to confirm antenatal infection with CMV (congenital CMV).

Investigation of section or scraping of oral mucous membranes for the presence of CMV DNA or virus antigen in the first 2 life of the child.
Examination of whole blood for the presence of CMV DNA or virus antigen in the first 2 life of the child; if the result is positive, the presence of CMV DNA in whole blood is shown to be significant.
Investigation of blood for the presence of antibodies of the IgM class to CMV using the ELISA method.
Measurement of the level of IgG antibodies in the blood at an interval of 14–21 dB.

It is possible to test the blood of mothers and children for anti-CMV IgG to equalize the strength of IgG antibodies in “paired siblings.”

Observation of children to confirm intranatal or early postnatal infection with CMV and the detection of active CMV (for the presence of the virus in the blood, swine and murine, anti-CMV IgM over the first 2 years of life).

Investigation of weed samples for the presence of CMV DNA and virus antigen in the first 4–6 years of a child’s life.
Examination of whole blood for the presence of CMV DNA or virus antigen in the first 4-6 years of a child’s life; if the result is positive, the presence of CMV DNA in whole blood is highly significant.
Investigation of blood for the presence of antibodies of the IgM class to CMV using the ELISA method.

Restriction of early childhood children, children, adults for suspicion of CMV infection.

Investigation of whole blood for the presence of CMV DNA and virus antigen.
Investigation of the presence of CMV DNA and virus antigen.
Investigation of blood for the presence of antibodies of the IgM class to CMV using the ELISA method.
Determination of the avidity index of antibodies of the IgG class to CMV using the ELISA method.
The concentration of IgG antibodies in the blood varies from 14 to 21 dB.

Obstruction of patients with suspicion of active CMV disease and manifest form of illness (CMV disease).

Examination of whole blood for the presence of CMV DNA and CMV antigen with obstructive musculoskeletal values ​​instead of CMV DNA in the blood.
Significance of CMV DNA in SMR, pleural samples, samples from bronchoalveolar lavage, biopsy of bronchial tubes and organs for evidence of a type of organ pathology.
Histological examination of biopsy and autopsy materials for the presence of cytomegalocells (preserved with hematoxylin and eosin).

Differential diagnosis of cytomegalovirus infection

Differential diagnosis of congenital CMV is carried out with rubella, toxoplasmosis, neonatal herpes, syphilis, bacterial infection, hemolytic disease of the newborn, birth trauma and spasm syndromes. Of greatest importance is the specific laboratory diagnosis of illness in the early life of the child, histological examination of the placenta using molecular diagnostic methods. In case of mononucleosis-like illness, infections include ESV, herpes viruses 6 and 7 types, acute HIV infection, as well as streptococcal tonsillitis and the onset of acute leukemia. In case of development of CMV disease of respiratory organs in children of early age, differential diagnosis should be carried out with cough, bacterial tracheitis or tracheobronchitis and herpetic tracheobronchitis. In patients with immunodeficiency, manifest CMV infection can be differentiated from Pneumocystis pneumonia, tuberculosis, toxoplasmosis, mycoplasma pneumonia, bacterial sepsis, neurosyphilis, progressive papilloma leukoencephalopathy, lymphatic infections. cephalitis. Polyneuropathy and polyradiculopathy CMV etiology is differentiated from polyradiculopathy caused by herpes viruses, Guillain-Barré syndrome, toxic polyneuropathy associated with the use of drugs, alcohol and narcotic, psychotropic speech. By promptly making an etiological diagnosis, assessing the immune status, standard laboratory tests, MRI of the brain and spinal cord, blood tests are carried out for the presence of CMV DNA, instrumental tests are carried out with CMR tests, lavage noi radini, pleural effusion, biopsy materials for the presence of DNA from the past .

Indications before consultation with other physicians

Indications before consultation with patients with CMV include the importance of the lungs (pulmonologist and phthisiatrician), central nervous system (neurologist and psychiatrist), eyes (ophthalmologist), hearing organs (otolaryngologist) and cystic cerebellum (oncohematologist).

Example of formulating a diagnosis

The diagnosis of manifest CMV is formulated as follows:

Gostra cytomegalovirus infection, cytomegalovirus mononucleosis;
- congenital cytomegalovirus infection, manifest form;
- HIV infection, stage of secondary illness 4 B (SNID): manifest cytomegalovirus infection (pneumonia, colitis).

Indications before hospitalization

In case of clinically severe CMV disease, hospitalization is indicated.

Treatment of cytomegalovirus infection

Diet mode

There is no need for a special treatment regimen for patients with CMV; restrictions are established for those leaving the patient and localization of the infection.

Medication-free treatment

Medicines, the effectiveness of which has been confirmed by controlled studies in the treatment and prevention of CMV infection, include antiviral drugs ganciclovir, valganciclovir, sodium foscarnet, cidofovir. Interferon and immunocorrector drugs are not effective for cytomegalovirus infection.

In case of active CMV (presence of CMV DNA in the blood), the drug of choice in the patient is human anticytomegalovirus immunoglobulin (neocytotect). To prevent vertical infection of the fetus with the virus, the drug is prescribed at a dose of 1 ml/kg per dose intravenously, 3 injections at an interval of 1-2 days.

To prevent the manifestation of illness in newborns with active CMV infection or in the manifest form of illness with minor clinical manifestations, Neocytotect is indicated at a dose of 2–4 ml/kg per 6 doses (after 1 or 2 days). If children with CMV or other infectious complications are present, neocytotect can be replaced with pentaglobin at a dose of 5 ml/kg every 3 days, repeated as necessary for the course or other immunoglobules. new for internal administration.

The use of neocytotect as monotherapy in patients who suffer from clinical manifestations, life-threatening illnesses, or the onset of important CMV infections is not indicated.

Ganciclovir and valganciclovir are the drugs of choice for treatment, secondary prevention and prevention of manifest CMV infection. Treatment of manifest CMV with ganciclovir is carried out according to the following scheme: 5 mg/kg internally 2 times per dose at an interval of 12 years for 14-21 days in patients with retinitis; 3-4 years - with severe leg or grass tract; 6 volumes or more – for CNS pathology. Valganciclovir is administered orally at a therapeutic dose of 900 mg 2 times per dose for the treatment of retinitis, pneumonia, esophagitis, enterocolitis of CMV etiology. The efficacy and effectiveness of valganciclovir is identical to parenteral therapy with ganciclovir. The criteria for the effectiveness of treatment and normalization of the patient’s status are significant positive dynamics in the results of instrumental investigations of CMV DNA in the blood. The effectiveness of ganciclovir in patients with CMV-diseases of the brain and spinal cord is limited, firstly, through the late establishment of an etiological diagnosis and inappropriate initiation of therapy, if irreversible changes in the central nervous system are already present. The effectiveness of ganciclovir, the frequency and severity of side effects when treating children who suffer from CMV disease can be compared with those for adult patients.

When a child develops a dangerous life of manifest CMV, treatment with gancyclovir is necessary. For the treatment of children with manifest neonatal CMV, ganciclovir is prescribed at a dose of 6 mg/kg intradermally for 12 years over 2 days, after the manifestation of the coronal effect of therapy, the drug will stagnate at a dose of 10 mg/kg every other day for 3 months.

For the sake of immunodeficiency, relapses of CMV disease are inevitable. For HIV-infected patients who have undergone treatment for manifest CMV, to prevent relapse of illness, supportive therapy (900 mg/dose) or ganciclovir (5 mg/kg/dose) is prescribed. Supportive treatment of patients with HIV infection who have suffered from CMV retinitis should be carried out against the background of HAART until the number of CD4 lymphocytes increases to more than 100 cells in 1 µl, which is not preserved less than 3 ms. The duration of the supported course for other clinical forms of CMV is not less than one month. In case of relapse, a repeat therapeutic course is prescribed. Treatment of the uveitis, which develops with a renewed immune system, is transmitted by systemic or periocular administration of steroids.

At this time, in patients with active cytomegalovirus infection, it is recommended to use a strategy of “back-up” etiotropic therapy to stop the manifestation of illness.

The criteria for recognizing preventive therapy are the presence of severe immunosuppression in patients (for HIV infection - the number of CD4 lymphocytes in the blood is less than 50 cells in 1 μl) and the value of CMV DNA in the High blood concentration in excess of 2.0 lg10 gene/ml or detected CMV DNA in plasma. The drug of choice for the prevention of manifest CMV infection is valganciclovir, which is stable at a dose of 900 mg/dose. The course is valid for at least a month. The criterion for administering therapy is the presence of CMV DNA in the blood. In organ recipients, preventive therapy is carried out for several months after transplantation. Side effects of ganciclovir or valganciclovir: neutropenia, thrombocytopenia, anemia, elevated serum creatinine levels, sagging skin, itching, dyspepsia, reactive pancreatitis.

Bathroom standard

Treatment course: ganciclovir 5 mg/kg 2 times per dose or valganciclovir 900 mg 2 times per dose, the duration of therapy becomes 14–21 days before symptoms of infection and CMV DNA from the blood disappear. In case of relapse of illness, repeat the treatment course.

Supportive therapy: valganciclovir 900 mg daily for at least a month.

Preventive therapy of active CMV infection in immunosuppressed patients to prevent the development of CMV infection: valganciclovir 900 mg daily for at least a month until CMV DNA is clear in the blood.

Preventive therapy for active CMV during pregnancy to prevent vertical infection of the fetus: neocytotect 1 ml/kg per dose internally, 3 injections at intervals in 2-3 years.

Preventive therapy of active CMV infection in newborns and young children to prevent the development of the manifest form of illness: Neocytotect 2–4 ml/kg per dose internally 6 administered under control of the presence of CMV DNA in the blood.

Forecast

With an early diagnosis of CMV pneumonia, esophagitis, colitis, retinitis, polyneuropathy and prompt initiation of etiotropic therapy, the prognosis for life and preservation of life is favorable. The later detection of cytomegalovirus pathology of the retina and the development of its high intensity lead to a persistent decrease in vision or its repeated loss. CMV infections of the legs, intestines, supraneural glands, brain and spinal cord can cause disability in patients or lead to death.

Conceptual terms of bad luck

The effectiveness of patients with CMV disease is reduced by no less than 30 points.

Medical examination

During pregnancy, women undergo laboratory testing to exclude active cytomegalovirus infection. Young children infected with CMV antenatally are monitored by a neurologist, otolaryngologist and ophthalmologist.

Children who have suffered from clinically severe congenital CMV infection are seen at the dispensary by a neurologist. Ailments after transplantation of the cerebrospinal fluid of other organs in the first river after transplantation must be tested at least once a month for the presence of CMV DNA in whole blood. Patients with HIV infection, where the number of CD4 lymphocytes is less than 100 cells in 1 μl, should be examined by an ophthalmologist and undergo a procedure to detect CMV DNA in blood cells at least once for 3 months.

Prevention of cytomegalovirus infection

Preventive approaches to CMV may be differentiated from the risk group. It is necessary to provide consultation to pregnant women (especially seronegative ones) regarding the problem of cytomegalovirus infection and recommendations to use barrier contraceptives in case of physical contacts, and to maintain the rules of special hygiene when monitoring children of a young age. It is necessary to urgently transfer vaginal seronegative women who work in infant wards, children's inpatient units and nursery-type facilities to work, which is not associated with the risk of their CMV infection. An important step in CMV prevention in transplantology is the selection of a seronegative donor as a seronegative recipient. There is no patented anti-cytomegalovirus vaccine.

What is cytomegalovirus infection?

Cytomegalovirus infection(Human Cytomegalovirus Infection, CMV -INCOPENSIA, Cytomague, Virusna of the Herring of the Slunny climbed, INCLUZIIN CITOMELIA, HIGHT INTRODUS) - Anthroponic, Scho Prot and Laten, Lightly, Latenly, Lightly Abo. Concern for various immunodeficiency conditions and gestation (due to the risk of intrauterine infection of the fetus).

Back in 1882 The German pathologist H. Ribbert discovered that in the nitric tubules of a dead-born baby there were giant cells with inclusions in the nucleus. Over the years, the stench has taken away the name of cytomegalic cells (Goodpasture E., Telbot F., 1921). Later, L. Smith and W. Rowe (1956) saw a virus that causes illness with the development of characteristic cytomegaly. It is called cytomegalovirus (CMV), and the disease itself is called cytomegalovirus infection.

What does cytomegalovirus infection provoke?

Newsletter of cytomegalovirus infection- DNA genomic virus of the Cytomegalovirus genus (Cytomegalovirus hominis) Pedrodini Vetaherpesvirina of the Herpesviridae family. There are 3 virus cases: Davis, AD-169 and Kerr. Complete reproduction of the virus in cells is possible without treatment. The virus is inactivated when heated or frozen; it is best preserved at room temperature. At -90 °C, it lasts for a long time, is evenly stable at pH 5.0-9.0 and collapses quickly at pH 3.0.

Reservoir and reservoir of infection- a person with a severe latent form of illness. The virus can be present in various biological secretions: mucus, which drains the nasopharynx, tears, cuts, evacuations, nasal fluids, cervical secretions.

Transmission mechanisms different, transfer routes- povitryano-spell, contact (direct and indirect - through household items) and transplacental. It is possible to become infected with this virus during transplantation of internal organs (either the heart or the heart) or blood transfusion from an infected donor. Intranatally infected infants occur more often than transplacentally. It is most dangerous for the fetus if the mother is infected in the first trimester of gestation. In such situations, there is the highest frequency of disruption of intrauterine development.

People are naturally friendly high or widespread latent infection. Clinical manifestations of infections that occur prior to opportunistic illnesses may result in primary or secondary immunodeficiency.

Main epidemiological signs of cytomegalovirus infection. Illness is registered everywhere, and antiviral antibodies are widespread, which are detected in 50-80% of adults. The diversity of patterns of CMV infection and the polymorphism of the clinical picture indicate the epidemiological and social significance of CMV infection. This disease plays an important role in transplantology, hemotransfusiology, perinatal pathology, which can cause prematurity, stillbirth, and birth defects. In adults, CMV infection increases as a concomitant illness due to various immunodeficiency conditions. Congestion of excessive fluid, stagnation of cytostatics and immunosuppressants, which will continue, will cause an increase in the frequency of CMV infection. In recent times, this concern has become especially relevant among those infected with HIV. In pregnant women with latent CMV infection, fetal symptoms are not immediately apparent. The prevalence of intrauterine infection is the primary source of infection for women during pregnancy. No seasonal or occupational specific illnesses were identified.

Pathogenesis (what happens?) during cytomegalovirus infection

In different ways, infection can be transmitted through the mucous membranes of the upper respiratory ducts, the scutulo-intestinal tract or other organs. The virus enters the home; The short-term viremia quickly ends with the localization of the pathogen when it is introduced into leukocytes and mononuclear phagocytes, where its replication begins. Infected cells increase in size (cytomegaly), develop a typical morphology with nuclear inclusions, which represents the acquisition of the virus. The creation of cytomegalic cells is accompanied by interstitial lymphohistiocytic infiltration, the development of nodular infiltrates, calcifications and fibrosis in various organs, glandular structures in the heads no brain.

The virus is long-lived and latently persists in organs rich in lymphoid tissue, being protected by the influx of antibodies and interferon. This very hour can suppress cellular immunity by direct infusion of T-lymphocytes. In case of various immunodeficiency conditions (in early childhood, in case of pregnancy, ingestion of cytostatics and immunosuppressants, HIV infection) and especially in case of impaired cellular immunity, additionally Among them, by direct infusion of the virus, possible reactivation of the pathogen and its hematogenous generalization affecting almost all organs and systems. At this rate, epitheliotropy to the virus is of great importance. It is especially pronounced in relation to the epithelium of venous tissues, which, when the virus influxes, transforms into cytomegal cells.

An active CMV infection is considered an indicator of defects in cellular immunity, and is included in the group of SNID-associating stations.

Symptoms of cytomegalovirus infection

International classification of illness X review
International Statistical Classification of Diseases and Related Health Problems 10th Revision Version for 2006 Do not classify cytomegalovirus infection as an infection that is transmitted by disease and such illnesses associated with CMV.
B25.0 Cytomegalovirus disease
B25.0 Cytomegalovirus pneumonitis
B25.1 Cytomegalovirus hepatitis
B25.2 Cytomegalovirus pancreatitis
B25.8 Other illnesses caused by cytomegalovirus
B25.9 Cytomegalovirus disease is nonspecific
B27.1 Cytomegalovirus mononucleosis
P35.1 Congenital cytomegalovirus infection

Among the various options for overcoming CMV infection, the most important are subclinical forms and latent viral carriage. The infection becomes clinically manifested in the minds of immunodeficiency. There is no single clinical classification of CMV infection. According to one classification, congenital CMV infection is seen in acute and chronic forms and incipient CMV infection in latent, acute mononucleosis or generalized forms x.

Congenital CMV infection. In most cases, the seizures do not manifest themselves clinically in the early stages of a child’s life, but in the later stages of their development they reveal a variety of pathologies: deafness, chorioretinitis with atrophy of the visual nerves, loss of intelligence, destruction of language. At the same time, in 10-15% of cases of congenital CMV infection, a clear cytomegalovirus syndrome develops. It must be kept within the terms of infection of the fetus during the hour of pregnancy.

.
- In early terms of vagutnosti lead to intrauterine death of the fetus or the birth of a child with various types of development: microcephaly, micro-macrogyria, hypoplasia of the leg, atresia, anomalies of the belly, defects interatrial and interventricular septa, sounding of the legen's stovbur.

If the fetus is infected in the late term of gestation When the development is not formed, the newborns’ teeth from the first days of life show signs of various illnesses: hemorrhagic syndrome, hemolytic anemia, hemorrhage of various origins (due to congenital hepatitis, liver cirrosis, liver atresia noble nobles). There may be a variety of clinical manifestations that indicate damage to various organs and systems: interstitial pneumonia, enteritis and colitis, polycystic subglottis, nephritis, meningoencephalus t, hydrocephalus.

- Gostra congenital CMV infection With the development of obvious cytomegalovirus syndrome, there is a tendency to generalization, severe transmission and secondary infections. Often there is an inevitable lethal end to the first years of a child’s life.

Chronic congenital CMV infection. Characteristic microgyria, hydrocephalus, microcephaly, cloudy crystalline and sloping body.

Pridbana CMV infection.
- In mature and older children In most cases, the episodes proceed latently, appear to be asymptomatic, or have a subclinical form with chronic recurrence.

- Gostra form of adventitious CMV infection. Often there may be no exact clinical symptoms, although the main clinical manifestations are similar to influenza, infectious mononucleosis or viral hepatitis.

- In adults with immunodeficiency conditions of various types (such as physiological immunosuppression in cases of susceptibility to HIV infection), as well as in children up to 3 years of age, CMV reactivation appears in the form of a generalized form of Various effects of organs and systems. The process may involve the central nervous system, legion, liver, nerves, scolio-intestinal tract, sechostatic system, etc. The most common diagnoses are hepatitis, interstitial pneumonia, enterocolitis, inflammation of various organs (usually in women), and encephalitis. In case of multiple organ infections, illness disrupts an important process, which may lead to sepsis. The result is often unpleasant.

The folds of the stravokhod, shlunka, and intestines (thick and thin) may open up. Viruses can lead to bleeding; with perforation, peritonitis develops. Cytomegalovirus hepatitis often develops. In patients with SNID, cytomegalovirus infection often leads to the development of chronic encephalitis or to the appearance of advanced encephalopathy. Apathy increases and over the next few months turns into dementia. Cytomegaly virus can cause the development of retinitis, which can lead to blindness in patients with SNID, as well as in people who have undergone organ transplantation. The plots of necrosis appear on the network, as they gradually expand.

Glad eyes it is necessary to differentiate from similar changes that are to be avoided in case of toxoplasmosis, candidiasis and herpetic infection.

Cream of HIV-infected cytomegalovirus infection is an important pathogenetic factor that complicates organ transplantation operations. When transplanting the liver, heart, or liver, cytomegalovirus causes prolapse, leukopenia, hepatitis, pneumonia, colitis, retinitis. Most often it lasts for 1-4 months after surgery. It should be noted that during the initial infection, the progression proceeds more important than after the activation of latent cytomegalovirus infection. The severity of the disorder and clinical manifestations depend on the stage of immunosuppression and the type of immunosuppressive drugs used.

Cytomegalovirus pneumonia develops in approximately 20% of patients; underwent surgery for a bone marrow transplant. The mortality rate for this group of patients is 88%. The maximum risk of development of the disease is observed from 5 to 13 years after transplantation. Most importantly, cytomegaly occurs in the elderly. In individuals who have undergone transplantation, cytomegalovirus infection may cause graft dysfunction.

- Demonstrate cytomegalovirus infection in vaginal. Vaginal CMV infection has a variety of clinical forms. With acute infection, liver, leg, and brain infections may develop. As a rule, the disease is characterized by illness, headache, fatigue, mucus discharge from the nose, bluish-blue discharge from the genitals, increased pain and soreness of the subcutaneous sinuses. Some characteristic symptoms appear in a complex: expressions resistant to therapy, hypertonicity of the uterine body, vaginitis, colpitis, hypertrophy, brushes and prematurely old placenta, rich in water. Against this background, the weight of the fetus often exceeds the gestational age, and also avoids the intimate attachment of the chorionic tissue of the placenta, the transfer of the normally expanded placenta, blood loss during the hour of the canopy, which reaches 1% of the weight for women, a clinic of admitted post-spapologous endometritis with development of menstrual cycle disturbances beyond.

Most often, cytomegalovirus infection occurs as a latent infection with periodic worsening. When making a diagnosis, laboratory results are of greatest importance. An additional role is played by the presence of a complex obstetric history, the threat of interruption of anterior vacancy, anterior canopies, and the birth of sick children with developmental problems. In women with chronic CMV, pseudoerosion of the cervix, endometritis, ovarian dysfunction, extragenital illness (hepatitis, chronic cholecystitis, pancreatitis, sechokamyana illness, chronic sinusitis) are more often present etc., pneumonia, chronic illness of the spine and nose).

Any manifestation of CMV infection is considered as an indicator of HIV infection. In this case, it is necessary to test the patient for antibodies to VIL.

Complication of cytomegalovirus infection
Complications vary widely and lie in clinical variants of illness: interstitial or segmental pneumonia, pleurisy, myocarditis, arthritis, encephalitis, Guillain-Barré syndrome, otherwise beware of Quite rarely. After the acute phase, asthenization and vegetative-vascular disorders persist for many years.

Diagnosis of cytomegalovirus infection

Differential diagnosis of CMV infection It is possible to understand through the variety or diversity of clinical manifestations.

For diagnostics of CMV infection It is necessary to perform 2-3 laboratory tests per hour. Follow up with drainage, washing water, removal from broncholegene lavage, cuttings, liquor, blood, breast milk, sectional material, biopsy. Due to the thermolabile nature of the virus, the material for investigation must be delivered to the laboratory no later than four years after collection.

Obstruction is carried out using virological, cytological, serological methods. Detection of specific changes in CMK cells is the most accessible method, its informativeness reaches 50-70%. The most reliable is the detection of the virus itself or its DNA in the material. The virological method is no longer the gold standard. This is the most reliable, but for this diagnosis it takes a lot of time, so the retrospective nature of the diagnosis does not allow for adequate therapy and prevention.

For diagnosis, it is not necessary to see the virus itself, it is enough to see the antigen. For this purpose, immunofluorescence reaction (RFI), enzyme-linked immunosorbent assay (ELISA), DNA-CMV hybridization, polymerase Lanzug reaction (PLR) are widely used.

PLR method Due to its high sensitivity, it detects DNA fragments of CMV and is allowed to become progressive. The most important advantage is the ability to diagnose the early stages of the process, latent and persistent infection, which has two main disadvantages. First of all, the low predictive value is due to the fact that PLR detects the DNA of the virus in its latent state. In other words, this method is not specific enough.

In the remaining years of the greatest expansion of the flood IFA method, which allows the detection of CMV antigen and specific antibodies of classes G and M. The detection of IgG is of other significance. It may be necessary to detect IgM immediately, especially for diagnosing the primary infection. If IgG is detected once, analysis of the level of its avidity (antigen absorption) can help differentiate between active and persistent infection.

Mothers must be aware that specific antibodies may not be detected in individuals with reduced immunity, protein starvation, etc. Testing of IgG must be carried out in male siblings at an interval of at least 10 days new

The recurrent form of CMV is diagnosed when the virus is detected again in seropositive individuals.

The diagnosis of intrauterine CMV is established over the first three years of life. The presence of IgM in a newborn up to two years of life indicates an internal uterine infection, and after that - about the onset.

Affinity and visibility of antibodies
The importance of diagnosing primary cytomegalovirus infection in patients has led to the development of the power of antibodies that are produced by the body in response to infection.

Two main powers of antibodies have been identified:
Affinity - the stage of specific affinity of the antibody to the antigen of the body
Availability is the stage of the binding of an antibody molecule to an antigen molecule

A close relationship has been established between them, whereby the greater the affinity, the lesser the antibody binds to the antigen (the greater the affinity). The stages of affinity and avidity make it possible to establish the age of class G antibodies and to make a new judgment about the duration of infection and the passage of the infectious process (latent passage, relapse). The first phase of infection is judged by the presence of virus-specific IgM antibodies, the presence of which in the body occurs over the course of several months. Enhancement of the IgG level occurs over many years. Low-affinity antibodies are created in the kidney, which are created when the virus is actively multiplying in the body and are stored for up to 1.5 months. I'm getting sick on the cob. Then the body produces high-affinity antibodies of the IgG class, which saves time. High-affinity antibodies are lost in the body immediately, providing immunity against infection.

For the purpose of primary and latent infection we mean affinity of antibodies to class G. If low-avidity IgG is detected in the blood, this indicates a primary infection. The presence of high-viscosity antibodies G indicates latent or past infection. If high-viscosity antibodies G and IgM are present in the body, it is possible to allow the latent infection to reactivate or for the virus to re-enter the body. talk about the secondary immune response once the pollutant enters the body or is contaminated (reactivation).

In many respects, relationships are referred to as the avidity index.

Avidity index up to 30% indicate the presence of low-visibility antibodies and are indicative of a primary infection, 30-40% - about the late stage of a primary infection or a recent infection, an index of over 40% - about a long-term infection.

Treatment of cytomegalovirus infection

Treatment of cytomegalovirus infection The situation is difficult, since interferon and many antiviral agents (acyclovir, vidarabine, virazole) turned out to be ineffective, and in some cases their stagnation leads to paradoxical reactions. Ganciclovir improves the development of cytomegalovirus retinitis, but is not very effective in treating diseases of the leg, brain, and thyroid gland organs. The drug foscarnet is a promising drug. It is possible to use anticytomegalovirus hyperimmune human immunoglobulin. For the treatment of women with a severe obstetric history, it is recommended to use immunomodulators (levamizole, T-activin).

Mononucleosis-like forms of infection do not require specific treatment.

For the treatment of important forms of CMV in immunocompromised individuals and intrauterine CMV in newborns, ganciclovir is used. It connects to the virus multiplication cycle and interrupts it. Relapses are possible after discontinuation of ganciclovir. The drug has low side effects such as neutropenia, thrombocytopenia, liver disease, and is therefore prescribed to children for life-changing indications. The bath is carried out under the control of a skin blood test for two days.

The use of interferons is considered effective.

At the current stage, it is important to combine antiviral drugs with interferons, which eliminates CMV (combining acyclovir with a-interferon), as well as mutually potentiating the antiviral action, reducing - toxicity of drugs (ganciclovir with interferon inducers, the most advanced combination). At the same time, methods are prescribed for the correction of immune dysfunction.

Specific anticytomegalovirus immunoglobulin is administered internally, 3 ml daily for 10 days. It contains 60% of CMV-specific antibodies.

Nonspecific immunoglobulins for intravenous administration (Sandoglobulin) are prescribed for the prevention of CMV infection in immunocompromised individuals. Their effectiveness is lower than that of specific immunoglobulins.

Effective for the prevention of CMV infection in seronegative recipients is the use of immunoglobulins in combination with acyclovir or valacyclovir.

Vaginally use 0.25% bonafton, oxolinov, rhodoxol, 0.5% tebrofen, florenal, 1% interferon, 3-5% acyclic ointment 3-5 times a day for 12-15 days (ointments must be changed skin 10-14 days ).

For the treatment of oral effusions, use vikoryst preparations in the form of rozchiniv, as well as 0.5% etonia, 1:5000 furatsilin, 1-5% aminocaproic acid; for fungal infections - 1% iodinol and 0.25% rhodoxol ointment.

For retinitis, damage to the central nervous system, pneumonia in immunocompromised individuals, the most effective drugs are ganciclovir or foscarnet, the course of treatment is 14-21 days.

Prevention of cytomegalovirus infection

Specific prevention not broken up. When transfusing blood, the blood of healthy donors is used to avoid the presence of antibodies to CMV, and also before transplantation of internal organs. It is indicated to administer a specific hyperimmune immunoglobulin with a prophylactic method in rhizic groups (recipients of the cerebrospinal fluid, heart, liver, and liver; those who are sick, who are taking off cytostatic drugs, and those who are sick). In the prevention of congenital infection, the advance of contact between sick and sick people is of great importance, in order to maintain the anti-epidemic regime in additional areas. Children who were born to mothers with CMV infection and do not show signs of infection do not benefit from breastfeeding. In children with CMV infection, repeated pregnancy can be recommended no sooner than after 2 days.

Ways to prevent CMV infection in pregnant women
It is impossible to completely turn off the risk of infection without following these rules to change the prevalence of CMV infection.

1. Wash your hands vigorously for 15-20 minutes, especially after changing your pet’s diapers
2. Never kiss children on the lips until they are 5 years old.
3. See for yourself and small children a variety of dishes and tableware
4. If you work in childcare facilities (nurseries, kindergartens), take leave during the hour of pregnancy or sharply limit contact with children.

There are no traces of any medications available if you have cytomegalovirus infection.

Infectionist

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Cytomegalovirus is a type of herpes virus. This illness can easily spread, which is why both young and old people often meet. This type of virus can remain in the human body for a long time in its inactive state. And since the immune system is strong, then there is no danger, manifesting itself as an initial cold, illness or sickness.

And in case of poor health and during pregnancy, cytomegalovirus can cause serious problems. The virus quickly infects the tissues of important organs, destroying their cells and disrupting their normal functioning. The external manifestation of illness suggests infection or pneumonia with accompanying enlargement of lymphatic nodes. And in this situation, a person is in a difficult situation that will soon end in death. It is therefore important to know how to treat cytomegalovirus in order to avoid serious complications.

Basics of Likuvannya

The main goal of therapy for cytomegalovirus is to reduce and suppress the negative impact of the viral infection on the human body. If we are talking about strong immunity, then the first subsidence of the virus proceeds very seriously and there is no need to escalate to a cure.
If the disease proceeds with all the accompanying symptoms and completely changes the body’s primary state, then consult a doctor, which includes a set of tests that will confirm or promptly diagnose lake If cytomegalovirus is detected, then comprehensive treatment is indicated.

Cytomegalovirus cannot be infected completely.

Focus all therapeutic approaches directly on reducing sickness symptoms, improving the immune system and speeding up the onset of relapses of illness.

The main method of treatment is to suppress the activity of the virus itself, which, after great therapy, is still lost in the human body forever. When you have a chance to completely reconsider your way of living, speed up your food. In addition, you will need to consistently take vitamin complexes.

In some cases, the doctor prescribes hospitalization of the patient with cytomegalovirus. In this case, it is recommended to limit any contact with other people, follow the rules of special hygiene, and throughout the entire period follow a healthy diet.

Drug therapy

Medications can help relieve symptoms and block the development of cytomegalovirus. Likuvannya in this case consists of:

• symptomatic symptoms;
• likov, to resist the virus;
• drugs of a syndromic nature;
• Immunoglobulins and immunomodulators;
• vitamin and mineral complexes.

Symptomatic conditions immediately soothe the inflammation, change it and relieve sick people. This can include vascular drops and various pain-relieving tablets. Treatments that resist the virus suppress the activity of the infection present in the body. Tse Panavir, Ganciclovir, Foscarnet, Cidofovir.

Panavir can suppress the infection and prevent the spread of the virus itself

Many drugs may have contraindications and cause side effects, so it is not possible to independently adjust dosage and engage in self-medication. Most often, ganciclovir is used to treat illness. This drug interferes with the expansion cycle of the virus and interrupts it. In this case, perform a blood test for two days.

Drugs of a syndromic nature accelerate the renewal of damaged tissues and organs, especially when illness occurs with complications. These medicines come in the form of a suppository, capsule and tablet, injection and various ointments. Immunoglobulins remove viral particles that linger in the body, binding them together. The following duties must be taken into account:

• Cytotect;
• Neocytotect;
• megalotect.

Check the specific effects of the internal language, which will last for five days. However, when prescribed to immunoglobulin, there is insurance and a low contraindication. This includes blood diabetes, the body's sensitivity to allergic reactions, nitric deficiency, the period of gestation and breastfeeding. Also, during the period of treatment with cytomegalovirus, a person simultaneously undergoes a course of other treatments, then immunoglobulin therapy is affected.

The effectiveness of treatment with antiviral drugs can be enhanced by the additional connection of interferons. Immune modulators have a positive effect on the immune system, improving and stimulating it in many people. Tse Neovir, Leukinferon, Viferon, Genferon. These drugs have proven themselves to be effective in treating infections during pregnancy (after 12 years of age) and in children.

Vitamin and mineral complexes help to support the body and its immunity, preventing relapses of illness from reoccurring. Therapy for the persistence of such disorders can take up to many days.

Treatment of cytomegalovirus so that women and men can eliminate their demise. Representatives of the strong state are prescribed immunoglobulins with antiviral drugs (Ganciclovir, Foscarnet). Cytomegalovirus in women is treated as an additional anti-inflammatory agent. Call Acyclovir and Genferon.

To reduce the temperature, which is associated with this type of virus, take Paracetamol. It is not recommended to take Aspirin as it may cause unwanted side effects.

Treatment of cytomegalovirus in children and vaginas

Choice of therapy if cytomegalovirus develops in children throughout life. Children under six years of age can be relieved of unacceptable symptoms by conservative treatment, and older children can be given antiviral medications. The stench suppresses the activity of a dangerous infection.

If CMV infection affects the eyes and legs, strong drugs (Foscarnet and Cidofovir) are prescribed. All stench may have increased toxicity and have a negative impact on the environment. Therefore, to treat the baby, the stench is only used if it is threatened by insecurity. Every time a consultation is convened in which the nutritional status of antiviral therapy is determined.

Foscarnet is effective against illness, but may have a number of side effects

Treatment of cytomegalovirus in a pregnant woman is also carried out with care, while respect is given to the health of the future baby. Since the virus occurs in an acute form, the woman takes Cytotect (2 ml per 1 kg of vaginal fluid) for seven days. If the infection has penetrated the entire canal of the cervix, then Viferon is prescribed. The duration of treatment with the drug is 21 days.

Therapy that stagnates can be shortened or delayed, depending on the level of side effects and the underlying clinical picture. In case of negative dynamics, the antiviral drug must be replaced. If cytomegaly proceeds silently and passively, then during the hour of pregnancy there is no cure for illness.

The specifics of therapy depend on the immune system

Treatment of cytomegalovirus in men and women who have normal immunity does not require the same specific steps. The therapy will be similar to that prescribed for colds. It is based on antipyretic and analgesic properties. And to reduce intoxication, the body is recommended to follow a regular nutritional regimen.

Treatment of cytomegalovirus infection in those patients who may be infected with malignant drugs or have undergone organ transplantation is required in hospital care. The main drugs are based on ganciclovir. However, it may provoke a number of side effects, so this therapy is not recommended during pregnancy, as well as for those who suffer from nitric deficiency. And the axis that affects the immune system, functions such as gancyclovir, is protected against the virus.

In HIV-infected patients, cytomegaly is treated with medications such as Foscarnet. For whom the doctor regularly monitors the obstructive ulcer, the remaining parts of the veins, as necessary, adjust the dosage of the drug. Sometimes there are side reactions to the body, such as boredom, impaired secretion and electrolyte metabolism.

A selection of traditional medicine recipes

Treatment of cytomegalovirus may be based on prescribed medications. It’s impossible to get rid of such illnesses without using traditional medicine. You can also support your immune system with the help of healthy recipes.

Tea prepared from raspberry and black currant leaves gives good results. Until then you can add a little honey. This type of drink will help a weakened body regain its strength and improve its health.

Brewed raspberry and currant leaves will add strength to a weakened body

To prevent infection, you can vikorize herbs and weeds. In equal proportions you need to mix birch hazelnuts, bagno, leuzea and low, wood, hemlock and thyme. Z|iz| Take 10 g of the drained milk and add a liter of boiled water. Let the food brew in the thermos throughout the day. Take ready-made homemade liquids, 50 ml tricha per day at the time of meals.

In a similar way, prepare a mixture of leuzea, velvet and licorice, chamomile and low, and kopjes. Or you can mix flaxseed, marshmallow root, raspberry and mother leaves, oman and squash. All components are taken in equal proportions, licorice root is added to them (four times more) and the resulting mixture is brewed for three years. Take 60 ml before the hedgehog.

In case of CMV, it is very important to turn on the clock and the dial before the diet. These products are liable to take on a new look. And if you do it regularly, you can reduce the risk of contracting the infection in a number of people.

If you have close people who have already contracted cytomegalovirus, you can stop the spread of the infection by cutting tea tree oil in the air. You need to work in this room if you are sick.

Prevention of CMV

Since cytomegalovirus is transmitted by the virus, as well as by natural means, doctors should preventively use condoms with an untrustworthy partner, and also avoid kissing someone they are wary of CMVI signs. Such symptoms may include weakness, sore throat, and high temperature.

Be especially careful with the guilty women. Since an infection of this kind is acquired during this important period, it poses a serious threat to children. Viruses and colds can be treated promptly. It is very important to take care of your body and your immune system. For this you can use the following methods:

• taking dietary supplements;
• maintaining special hygiene;
• creating the right diet.

Throughout the day you can drink lemongrass or echinacea brews. And if you add ginseng to these components, you can also take away the anti-inflammatory and immune-stimulating effect.

Everyone who has dealt with the described illnesses is encouraged to learn about those who can cure cytomegalovirus. Otherwise, you really won’t be able to get infected. Then, with additional complex therapy and early preventive measures, the virus can be suppressed, and you will be in a passive state for the entire hour.

What's this? Cytomegalovirus is a member of the herpesvirus family. This virus has become more widespread, and antibodies to cytomegalovirus can now develop in approximately 10-15% of children and 40% of adults. Below we will provide a full description of this illness, as well as a look at the causes, symptoms and methods of treating cytomegalovirus.

Causes of infection with cytomegalovirus

Cytomegalovirus (from the Latin Cytomegalovirus) is actually a relative of the herpes virus, which is part of the group of herpes viruses, which includes herpes and cytomegalovirus, and two other illnesses such as infectious mononucleosis and .

The presence of cytomegalovirus is indicated in the blood, semen, semen, vaginal mucus, and also in tears, which means the possibility of infection with it through close contact with these species of biological organisms.

How is infection detected? Infection with cytomegalovirus can occur:

• when removing infected objects,
• in case of blood transfusion and infuse with a droplet-dotted way,
• and also in case of official contact,
• under the hour of light and humidity.

This virus is also found in blood, in feces, in cervical tissue, in sperm and in breast milk.

If a person has already become infected with cytomegalovirus, then they will carry it for the rest of their lives.

Unfortunately, recognizing the presence of cytomegalovirus is not immediately possible - illness is subject to an incubation period that can last up to 60 days. During this period, you may not be able to tell yourself that you are ill, unless you experience a lack of sleep and rapid sleep, which in most seizures can be provoked by stress, hypothermia, or a profound decrease in the immune system.

Spreading into the blood, cytomegalovirus triggers a pronounced immune reaction, which is manifested in the fermented dry protein antibodies - immunoglobulins M and G (IgM and IgG) and the antiviral cellular reaction - created lymphocytes CD 4 and CD 8.

People who do not have a normal immune system may be infected with cytomegalovirus and not know about it, because parts of the immune system are controlled by the virus in a suppressed state, and then have an asymptomatic illness without developing illness. In isolated cases, in people with normal immunity, cytomegalovirus can cause mononucleosis-like syndrome.

In people with weak or weakened immunity (VIL infections, cancer patients, etc.), cytomegalovirus causes severe illness, and the following levels occur:

• eye,
• legen,
• brain and herbal system,
• which will result in death.

Cytomegalovirus is most dangerous in two cases. This applies to people with weakened immune systems and children who were infected while the fetus was in the womb, who became infected with the virus during pregnancy.

Symptoms of cytomegalovirus in women

In women, symptoms of cytomegalovirus appear separately from the form of the disease. Sickness begins with the incubation period, which becomes 20-60 days. At this time, the disease is actively multiplying in the cells, and the signs of illness are daily.

Since the woman’s immunity is not weakened, she will not be able to avoid the usual symptoms of illness. In certain situations, a woman can be turbulent:

• signs to predict the flu state
• slight increase in temperature to 37.1°C,
• weakness,
• minor illness.

Signs of people

Based on the symptoms of cytomegalovirus in humans, you can see the following symptoms:

• temperature rise;
• chills;
• headaches;
• swelling of the mucous membranes and nose;
• increase in lymph nodes;
• undead;
• hanging on the skin;
• the ignitions are sick, in the snowdrifts.

As you can note, the listed manifestations are similar to the manifestations that are indicated for GRZ and GRVI. It is important to ensure that symptoms of illness only appear 1-2 months after infection, or after the incubation period is completed.

Diagnostics

We know what cytomegalovirus is, and now let’s find out how to diagnose illness. To diagnose infections that are transmitted by viral infections (IPSS), methods are used based on the virus detected in the body that causes illness. However, for these sick people, everything is different. This can also be detected through special investigation of blood, samples, samples, smears, sperm and scrapers, which are taken from organs during primary or persistent infections.

1. The diagnostic method involves laboratory determination in the blood of specific antibodies to cytomegalovirus - immunoglobulins M and G. The presence of immunoglobulins M can indicate primary infection with cytomegalovirus or reactivation of chronic cytomegalovirus. megalovirus infection. High titers of IgM in vaginas may threaten fetal infection. IgM elevation is detected in the blood 4-7 days after infection with cytomegalovirus and persists for 16-20 days.
2. The elevation of immunoglobulin G develops during the period of extinction of the activity of cytomegalovirus infection. Its presence in the blood indicates the presence of cytomegalovirus in the body, but does not reflect the activity of the infectious process.
3. To identify cytomegalovirus DNA in blood cells and mucous membranes (in materials from scrapings from the urethra and cervical canal, in sputum, mucus, etc.), the method of PLR diagnostics (polymerase lancin reaction) is used. ї). Particularly informative is the use of PCR, which provides information about the activity of cytomegalovirus and the infectious process that is associated with it.
4. The diagnosis of cytomegalovirus infection is based on the presence of cytomegalovirus in clinical material or upon a several-fold increase in antibody titer.

Warto note that tests for cytomegalovirus should be given to women who are planning to become pregnant. It is also necessary to carry out a similar analysis for those people who often suffer from colds, since colds may manifest themselves as infections.

It is necessary to treat cytomegalovirus infection in a comprehensive manner; clinical therapy must include the functions directly aimed at combating the virus, at the same time those responsible for promoting the harmful functions of the organ. change and improve immunity. Nowadays, such a method has not yet been found, which, once the cytomegalovirus is completely eliminated, is lost from the body again.

The main method of treating cytomegalovirus is to suppress its activity.. People who are carrying this virus must follow a healthy lifestyle, eat plenty of food and supply the body with the necessary amount of vitamins.

Because, in most cases, the body itself is capable of contracting cytomegalovirus, treatment of the infection associated with it is often limited by a weakening of symptoms and a change in the suffering of the patient.

To reduce the temperature, which is typical for all forms of cytomegalovirus infection, use the standard paracetamol. It is not recommended to take aspirin through possible side effects associated with the viral nature of illness.

It is still important for those with this illness to lead a normal and correct way of living, which will provide people with the necessary amount of fresh air, balanced meals, flow and all the factors that affect them toilet.

In addition, there is a large number of immunomodulatory drugs that are used to improve the immune system. Treatment with immunomodulators can be harmful to many people, and this means treatment without a medicine. It should be noted that similar treatment is possible in this case, since cytomegalovirus is latent, so drugs are used for prevention, but not for treatment.

Prevention

It is important to note that cytomegalovirus is most dangerous in the case of the initial infection, so it is necessary to avoid all incidents in contact with already infected people and to prevent this infection. And such care is especially important for pregnant women, as they do not carry cytomegalovirus. To protect your health and the health of your baby, important women need to take care of the condition.

Prevention of cytomegalovirus for others comes down to following the basic rules of special hygiene.

1. It is not advisable to enter into new intimate contacts without a condom: this series of doctors is repeated more and more often and is relevant like no other.
2. When bathing with sick people, you cannot use only washing utensils and utensils, you must keep your life clean, and carefully wash your hands after contact with dirty and other objects that other people have handled.

In addition, it is important to take care of your immune system, maintaining a healthy immune system, to prevent the rapid entry of cytomegalovirus into the body, and to prevent the development of acute cytomegalovirus infection. ї.

Zmist

Viruses, when entering the body, do not show any impact on the resistance of the immune system. Well, people will fall ill and experience the approach of seasonal vitamin deficiency, as if they are insecure, they will immediately support the lack of health, and give complications. The especially dangerous cytomegalovirus is a relative of herpes.

Cytomegalovirus virus

This is a life-long infection, which however penetrates into children and adult bodies, and matures asymptomatically for a long time. Without a significant influx of pathogenic agents, many fatalities can pass through the stages of calm and remission. Cytomegalovirus infection is a member of the herpesvirus family and can be diagnosed in a patient’s body by laboratory tests.

Please note that due to the presence of symptoms of the virus, it is not safe for those traveling abroad, as the fragments can infect a non-viral illness. However, since cytomegalovirus is present, the information provided can now be withdrawn from your hospital physician. If in the medical record there is a code with the symbols MKH-10, its decoding is as follows: cytomegalovirus infection in the patient.

How is cytomegalovirus transmitted?

People have become the bearers of the pathogenic infection. Remnants of the plant are found in high concentrations in biological areas, and such samples become the main source of pathogenic flora. The evidence for how people become infected with cytomegalovirus is obvious - through kissing, sexual contact, drinking or sharing a virus. It is also impossible to eliminate the risk of infection during blood transfusion, transmission of infection to the fetus from the biological mother.

Symptoms

These are the diagnoses that cannot be overcome by current medicine. In the case of the herpes virus and HIV, it is impossible to blame cytomegalovirus again - which is also understandable. The microscopic infection penetrates the blood and triggers the body’s immune response in the form of protein antibodies – lgg and lgm. As a result, there may be a suppression of the immune system and the formation of harmful flora. As cytomegalovirus infection rapidly develops in the systemic bloodstream, symptoms in the body are as follows:

• fever;
• meat weakness;
• a sharp decline in productivity;
• inflammation and lymph nodes;
• problems with hearing, vision, hand coordination (at the important stage).

In the latent form of the disease, alarming symptoms do not develop, and the patient will never be aware of the spread of a fatal infection in the body. It is unlikely that you will get sick, and there are no chronic or inflammatory diseases associated with the immune system; It is obvious that CMV is the cause of illness in the body, which threatens it.

At the wives

It is already clear that the infection causes illness, but it is important to add that if you are pregnant, you should reduce your risk of unproductive immunity. Otherwise, the symptoms of cytomegalovirus in women are similar to the symptoms of the disease in the human body. This means that wider symptoms of influenza may be evident. Tse:

• body temperature 37 degrees;
• body aches;
• more in the snow;
• meaty weakness.

These symptoms are characteristic of the acute stage of the disease, as they are now known. Cytomegalovirus becomes chronic and susceptible to relapse, especially in cases of weakened immunity. For an infected woman, it is especially dangerous to get sick, since the planned pregnancy will not come or end with the weekend.

When you are pregnant

During intrauterine development, the organism of the future breed is weakened, which is susceptible to infection and further expansion of the pathogenic infection. Cytomegalovirus in vaginas can pose a serious threat to the mother and child, and the clinical result may not be predictable. Tips for a woman’s health in a “healthy state” can be as follows:

• instant abortion;
• birth hemorrhage;
• rich water;
• pathologies of the placenta;
• ailments of the sechostate area;
• fetal death;
• non-existence of vaginity;
• problems with gynecology.

Inherits for a child that start in the prenatal period are:

• born deaf;
• vice of the heart;
• hydrocephalus;
• ailments of the eyes and teeth;
• destruction of the rose flower.

Cytomegalovirus in newborns

If the mother becomes infected with a non-virus infection when the fetus is infected with wine, the baby is born with cytomegalovirus. If a pregnant woman was already carrying the virus at the time of conceiving, she may not be born healthy. As soon as the germ of cytomegalovirus is detected, the microbe transforms the new person into a disabled person from the first days of life. Doctors recommend reaching the planned stage of pregnancy with special care.

In people

Illness can appear in the human body, in its distressing hour it disguises itself as the classic symptoms of HRV, physical activity intensifies, and a loss of strength occurs. Genital cytomegalovirus is an asymptomatic disease, but in case of weakened immunity, signs of illness may be classified as follows in the body:

1. Basic signs. This is a general intoxication of the body due to acute illnesses and low-grade body temperature.
2. Other symptoms. Pathology of the sechostate area, if the pathological process extends to the urethra.
3. Clinical symptoms. Sagging skin, enlarged lymph nodes, nasal congestion, systematic migraine attacks, underlying weakness of the body.

Cytomegalovirus – diagnosis

The patient may have a feeling that he has a cytomegalovirus infection, but it is difficult to detect how to accurately diagnose the disease. Medical practitioners are also working together to recommend comprehensive treatment based on the concentration and composition of biological substances in the body. The following procedures are necessary:

• serological surveillance of the presence of a pathogenic infection;
• cytological analysis of tissues reveals the stage of damage to tissue structures;
• ELISA for simple and rapid identification of antibodies in the blood;
• light microscopy to identify the level of tissue and cell damage;
• DNA diagnostics based on cell modifications;
• PLR for treatment, a pathogenic infection has occurred;
• External analysis of the section to identify additional pathological processes in the body.

Blood test

Laboratory investigations help to determine the concentration of infection in the biological community, and its stage of development. For example, with serological follow-up, signs of cytomegalovirus indicate the activity of a characteristic disease. Alternatively, the decrease in immunoglobulin M characterizes the relapse stage, and the increase in the norm of immunoglobulin G is more indicative of the remission period of this illness.

How to treat cytomegalovirus

Even though the doctors did not work, they did not carry out any therapeutic approaches, they did not attempt to get the clinical patient back into uniform. Treatment of cytomegalovirus infection directly improves immunity, preventive treatment, and reduces the rate of relapses of the underlying illness. Doctors know what CMV is, and how to kill it, until they never figure it out. The approach to the problem is complex, including the use of foot remedies:

1. Antiviral drugs: Panavir, Ganciclovir, Forscanet.
2. Interferon: Viferon, Cycloferon, Leukinferon.
3. Immunoglobulins: Megalotect, cytotect.
4. Symptomatic treatment: for medical indications.

In children

If a child is ill, the choice of intensive therapy should be based on the age-old category. Children under 6 years of age can alleviate the symptoms of a cold using conservative methods, and older children can also take antiviral drugs to reduce the activity of a dangerous infection. In the end, it is important to remember that such medications may have a toxic effect and may have side effects. Before treating cytomegalovirus with medication, you need to consult with your hospital pediatrician.

Chi dangerous cytomegalovirus

Unsafe infections can infect people who come into contact with others. You don’t need to be kind, because it’s your immune system. However, this year the immune system is noticeably weaker, and cytomegalovirus continually destroys internal organs. The nervous system suffers. For a sick patient with a dangerous cytomegalovirus, doctors always firmly confirm, in which it does not matter - an adult victim or a child.

Prevention

1. Maintaining the rules of special hygiene is of great importance for stopping the activity of a pathogenic infection in the body.
2. It is necessary to promptly treat viral and cold illnesses and take preventive measures.
3. If cytomegalovirus manifests itself, it is necessary to immediately unfasten your clothes, identify the cause of the pathology, and determine a treatment regimen.
4. If the smear is positive, the patient will have a long time to rejoice.
5. The best way to prevent cytomegalovirus is to improve the immune system using medications and natural methods.

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Respect! The information provided by the statistics is of an informative nature. Statistic materials are not available until you receive your own attention. Only qualified physicians can make a diagnosis and recommend treatment based on the individual characteristics of the individual patient.

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