Cytomegalovirus CMV

• Facts:
  Trasmission via sexual contact, in breast milk, via respiratory droplets in nursery/day care centers, and through blood transfusions
  
  Systemic infection can resemble infectious mononucleosis
• History / PE:
  1) CMV retinitis
  High rate of retinal detachment
  
  2) CMV pneumonitis
  Late complication in post-BMT patients
  Pneumonitis AND colitis
  
  3) CMV esophagitis
  Seen in AIDS patients
  Large, shallow, linear, and superficial ulcers
  
  4) CMV CNS involvement
  Polyradiculopathy, transverse myelitis, and subacute encephalitis
• Diagnosis:
  Virus isolation
  Tissue examination
  Serum PCR
• Treatment:
  Ganciclovir
• Differential Diagnosis:
  HSV esophagitis (multiple, well circumscribed ulcers, treat with acyclovir )