Cytomegalovirus (CMV, HHV5)- Asymptomatic/subclinical infection in healthy persons, but severe infections in infants infected before birth and immunosuppressed patients (especially with HIV or organ transplantation); transmission via body fluids
- Immunosuppressed patient: infection can lead to ocular involvement (CMV necrotizing retinitis), CNS involvement (meningoencephalitis), GI tract involvement (inflammation with painful ulcerations), and lung abnormalities (pneumonitis)
- Presents with wide variation: asymptomatic or mono-like symptoms; polymorphous eruption including vesicles, nodules, or verrucous plaques
- Histology: cytomegalic endothelial and/or epithelial cells enlarged with intranuclear inclusions, eccentrically displaced nucleus with halo (“owl’s eye” inclusion bodies)
- In patients with HIV can present with chronic perianal and lower extremity ulcerations, esophagitis, pneumonitis, chorioretinitis
- Treatment of choice is ganciclovir
|
