Cytomegalovirus infection classification: Difference between revisions

Jump to navigation Jump to search
m (Bot: Removing from Primary care)
 
(5 intermediate revisions by 2 users not shown)
Line 4: Line 4:


==Overview==
==Overview==
Cytomegalovirus infection can be classified based on the organ system involved into the following: CMV retinitis, CMV colitis, CMV esophagitis, CMV pneumonitis and CMV encephalitis.
[[Cytomegalovirus infection]] can be classified based on the organ system involved into the following: [[CMV retinitis]], [[Colitis|CMV colitis]], [[CMV]] [[esophagitis]], [[CMV]] [[pneumonitis]] and [[CMV]] [[encephalitis]].


==Classification==
==Classification==
Cytomegalovirus infection can be classified based on the organ system involved into the following:
[[Cytomegalovirus infection]] can be classified based on the organ system involved into the following:<ref name="urlwww.idsociety.org">{{cite web |url=https://www.idsociety.org/uploadedFiles/HIVMA/Guidelines_Patient_Care/HIVMA_Standards_Practice_Guidelines/HIV_Guidelines/Guidelines_Content/adult_oi.pdf |title=www.idsociety.org |format= |work= |accessdate=}}</ref>
*CMV [[retinitis]]
*CMV [[pneumonitis]]
*CMV [[esophagitis]]
*CMV [[colitis]]
*CMV [[encephalitis]]
===CMV retinitis===
===CMV retinitis===
*It is the most common clinical manifestation of [[cytomegalovirus]] infection.  
*It is the most common clinical manifestation of [[cytomegalovirus]] infection.  
Line 13: Line 18:
*In patients with [[CD4]] < 50cells/mm³ bilateral retinal involvement is high.
*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 defect|visual field defects]] whereas central retinal lesions or lesions impinging on the [[macula]] or [[optic nerve]] are result in decreased [[visual acuity]] and central [[Visual field defect|field defects]].  
*Peripheral [[retinitis]] can be asymptomatic or present with floaters, scotomata, or peripheral [[Visual field defect|visual field defects]] whereas central retinal lesions or lesions impinging on the [[macula]] or [[optic nerve]] are result in decreased [[visual acuity]] and central [[Visual field defect|field defects]].  
*On fundus examination the following findings can be demonstrated:  
*On [[fundus]] examination the following findings can be demonstrated:  
**Fluffy yellow-white retinal lesions, with or without intraretinal hemorrhage.
**Fluffy yellow-white retinal lesions, with or without intraretinal hemorrhage.
**[[Inflammation]] of the [[vitreous]] can be demonstrated in patients with severe [[immunosuppression]].
**[[Inflammation]] of the [[vitreous]] can be demonstrated in patients with severe [[immunosuppression]].
**Blood vessels appear sheathed.
**[[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.
**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===
===CMV colitis===
Line 41: Line 46:
*'''CMV Encephalitis'''
*'''CMV Encephalitis'''
**Patients with [[cytomegalovirus]] [[encephalitis]] presents with [[fever]], [[lethargy]] and [[confusion]].  
**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.
**[[Cerebrospinal fluid]] demonstrates lymphocytic [[pleocytosis]], low-to-normal [[glucose]] levels, and normal-to-elevated [[protein]] levels.
*'''CMV Ventriculoencephalitis'''
*'''CMV Ventriculoencephalitis'''
**Patients have an acute onset of symptoms with focal neurological deficits, [[cranial nerve palsies]], [[nystagmus]] and rapid progression to death.
**Patients have an acute onset of symptoms with focal neurological deficits, [[cranial nerve palsies]], [[nystagmus]] and rapid progression to death.
Line 48: Line 53:
**Patients present with similar features of [[Guillain-Barre Syndrome|Guillian Barre Syndrome]].  
**Patients present with similar features of [[Guillain-Barre Syndrome|Guillian Barre Syndrome]].  
**Patients with [[bladder incontinence]] and [[paraplegia]] with gradual worsening of symptoms over weeks.
**Patients with [[bladder incontinence]] and [[paraplegia]] with gradual worsening of symptoms over weeks.
**[[Cerebrospinal fluid|Cerebrospinal fluid analysis]] demonstrates neutrophilic pleocytosis, low [[glucose]] levels and elevated [[protein]] levels.
**[[Cerebrospinal fluid|Cerebrospinal fluid analysis]] demonstrates neutrophilic [[pleocytosis]], low [[glucose]] levels and elevated [[protein]] levels.
 
==References==
{{Reflist|2}}
 
[[Category:Emergency medicine]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Neurology]]
[[Category:Neurosurgery]]
[[Category:Gastroenterology]]
[[Category:Ophthalmology]]

Latest revision as of 21:12, 29 July 2020

Cytomegalovirus infection Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Cytomegalovirus infection 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

Cytomegalovirus infection classification On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Cytomegalovirus infection classification

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Cytomegalovirus infection classification

CDC on Cytomegalovirus infection classification

Cytomegalovirus infection classification in the news

Blogs on Cytomegalovirus infection classification

Directions to Hospitals Treating Cytomegalovirus infection

Risk calculators and risk factors for Cytomegalovirus infection classification

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aravind Kuchkuntla, M.B.B.S[2]

Overview

Cytomegalovirus infection can be classified based on the organ system involved into the following: CMV retinitis, CMV colitis, CMV esophagitis, CMV pneumonitis and CMV encephalitis.

Classification

Cytomegalovirus infection can be classified based on the organ system involved into the following:[1]

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

CMV esophagitis

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 and diagnosis confirmation requires a correlation of the clinical features to imaging findings.

Neurologic disease

Cytomegalovirus infection of the neurological system includes dementia, ventriculoencephalitis and polymyeloradiculopathies. Diagnosis of neurological disease requires correlation between the clinical symptoms and a positive PCR for cytomegalovirus of the cerebrospinal fluid.

References

  1. "www.idsociety.org" (PDF).