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==Overview==
{{Roseola}}
{{CMG}}:{{AE}}{{DAMI}}


==Classification==
Cytomegalovirus infection can be classified based on the organ system involved into the following:
===CMV retinitis===
*It is the most common clinical manifestation of cytomegalovirus infection.
*Retinitis is initially unilateral but progress to affect the contralateral side in the absence of therapy and immunosuppression.
*In patients with CD4 < 50cells/mm³ bilateral retinal involvement is high.
*Peripheral retinitis can be asymptomatic or present with floaters, scotomata, or peripheral visual field defects whereas central retinal lesions or lesions impinging on the macula or optic nerve are result in decreased visual acuity and central field defects.
*On fundus examination the following findings can be demonstrated:
**Fluffy yellow-white retinal lesions, with or without intraretinal hemorrhage.
**Inflammation of the vitreous can be demonstrated in patients with severe immunosuppression.
**Blood vessels appear sheathed.
**If left untreated, retinitis is a rapidly progressive condition and on fundus examination it demonstrates a characteristic brushfire pattern, with a granular, white leading edge advancing before an atrophic gliotic scar.
===CMV colitis===
*Colitis is seen in 5 to 10% of patients with AIDS and cytomegalovirus end organ disease.
*Colitis presents with weight loss, anorexia, abdominal pain, debilitating diarrhea, fever and malaise. Patients with perforation of the bowel present with acute abdominal pain.
*CT abdomen in patients with cytomegalovirus colitis demonstrates colonic thickening.
*Complications of cytomegalovirus colitis include bowel perforation and hemorrhage.
===CMV esophagitis===
*Cytomegalovirus  esophagitis can be seen in few patients with AIDS and cytomegalovirus end organ disease.
*Patients present with symptoms of odynophagia, nausea, mid-epigastric or retrosternal discomfort and fever.
===CMV pneumonitis===
*Cytomegalovirus pneumonitis is a uncommon condition and is usually asymptomatic.
*It is usually diagnosed on bronchoalveolar lavage and co-exists with an underlying pulmonary infection.
*Chest X-Ray demonstrates diffuse pulmonary interstitial infiltrates.


===Neurologic disease===
==[[Roseola overview|Overview]]==
Cytomegalovirus infection of the neurological system includes dementia, ventriculoencephalitis and polymyeloradiculopathies.
*'''CMV Encephalitis'''
**Patients with cytomegalovirus encephalitis presents with fever, lethargy and confusion.
**Cerebrospinal fluid demonstrates lymphocytic pleocytosis, low-to-normal glucose levels, and normal-to-elevated protein levels.
*'''CMV Ventriculoencephalitis'''
**Patients have an acute onset of symptoms with focal neurological deficits, cranial nerve palsies, nystagmus and rapid progression to death.
**Presence of periventricular enhancement on CT or MRI is highly suggestive of CMV infection.
*'''CMV polyradiculomyelopathy'''
**Patients present with similar features of Guillian Barre Syndrome.
**Patients with bladder incontinence and paraplegia with gradual worsening of symptoms over weeks.
**Cerebrospinal fluid analysis demonstrates neutrophilic pleocytosis, low glucose levels and elevated protein levels.


==Pathogenesis==
==[[Roseola historical perspective|Historical Perspective]]==


==Epidemiology and Demographics==
==[[Roseola classification|Classification]]==
Cytomegalovirus (CMV) infects approximately 40-90% of the world population.<ref name="pmid27526428">{{cite journal| author=Pytka D, Czarkowska-Pączek B| title=[CMV infection in elderly]. | journal=Przegl Lek | year= 2016 | volume= 73 | issue= 4 | pages= 241-4 | pmid=27526428 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27526428  }} </ref>
 
==[[Roseola pathophysiology|Pathophysiology]]==
 
==[[Roseola causes|Causes]]==
 
==[[Roseola differential diagnosis|Differentiating Any Disease from other Diseases]]==
 
==[[Roseola epidemiology and demographics|Epidemiology and Demographics]]==
 
==[[Roseola risk factors|Risk Factors]]==
 
==[[Roseola screening|Screening]]==
 
==[[Roseola natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
 
==Diagnosis==
[[Roseola history and symptoms|History and Symptoms]] | [[Roseola physical examination|Physical Examination]] | [[Roseola laboratory findings|Laboratory Findings]] | [[Roseola electrocardiogram|Electrocardiogram]] | [[Roseola chest x ray|Chest X Ray]] | [[Roseola CT|CT]] | [[Roseola MRI|MRI]] | [[Roseola echocardiography or ultrasound|Echocardiography or Ultrasound]] | [[Roseola other imaging findings|Other Imaging Findings]] | [[Roseola other diagnostic studies|Other Diagnostic Studies]]
 
==Treatment==
[[Roseola medical therapy|Medical Therapy]] | [[Roseola surgery|Surgery]] | [[Roseola primary prevention|Primary Prevention]] | [[Roseola secondary prevention|Secondary Prevention]] | [[Roseola cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Roseola future or investigational therapies|Future or Investigational Therapies]]
 
==Case Studies==
[[Roseola case study one|Case #1]]

Latest revision as of 19:04, 22 May 2017


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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]:Associate Editor(s)-in-Chief: Omodamola Aje B.Sc, M.D. [2]


Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Any Disease from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Chest X Ray | CT | MRI | Echocardiography or Ultrasound | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Secondary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

Case Studies

Case #1

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