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Cytomegalovirus (Diagnosis (History (DH
Meds, allergies, FH
…
Cytomegalovirus
Diagnosis
Examination
Neonatal
Jaundice, hepatosplenomegaly, hypotonia,
purpura, eye/hearing problems, cerebral palsy
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Investigations
Bloods
FBC (may have high WCC), CRP, U+E, LFT
Serology (CMV IgM or IgG) or PCR
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-
History
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FH
Immunocompromised, recently unwell
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SH
Living arrangements, occupation/school,
smoking, alcohol, drugs
PC/HPC
Fever, malaise, fatigue, sore throat,
enlarged LNs, recent unwell contact
Pathophysiology
Transmission
Saliva, genital, breastmilk, blood transfusion,
organ transplantation
Mechanism
Mild or subclinical infection in immunocompetent
Morbidity in developing foetus or immunocompromised
Can become latent and reactivate
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Management
Conservative
Information, advice, support
Self care (fluids, rest)
Medical
Antivirals
Indication: serious infection i.e. immunocompromised
E.g. ganciclovir IV, valganciclovir PO
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Prevention
Blood products
CMV -ve, irradiated blood for
transfusion patients, HIV or leukaemia
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