see also:

• viruses
• EBV / glandular fever / infectious mononucleosis

• CMV is a member of the Herpesviridae family
• ~60% of western populations have been infected with CMV, most are asymptomatic, but it may become reactivated if T-cell immunity falls
• appears to be the cause of glioblastoma multiforme ¹⁾
  • CMV proteins are highly expressed in over 90% of GBM tumors

• if symptomatic, incubation period is 9-60 days
• may cause:
  • a flu-like illness with pharyngitis, perhaps mild pneumonitis with fine crackles
  • PUO
  • lymphadenopathy
  • splenomegaly

• may result in a mononucleosis syndrome and affect most organs in the body:
  • PUO
  • pneumonitis
  • hepatitis
  • encephalitis
  • myelitis
  • colitis
  • uveitis
  • retinitis
  • neuropathy
  • rarely:
    • Guillain-Barre syndrome (GBS)
    • pericarditis
    • myocarditis
    • thrombocytopenia
    • haemolytic anaemia

• CMV normally remains dormant but may become reactivated if T-lymphocyte mediated immunity becomes compromised as in:
  • AIDS
  • immunosuppressants such as azathioprine Rx
• CMV viraemia may then lead to:
  • severe pneumonitis
  • secondary haemophagocytic syndrome
• if CMV reactivation occurs during breastfeeding:
  • the ensuing immune response may affect milk composition, neonatal gut flora with lower levels of beneficial flora, and impaired development of gut microbiome and impaired infant growth. ²⁾