Description
Cytomegaly is caused by a viral infection, which shows an inapparent progression, however leads to serious symptoms with immune-compromised patients and newborns.
The cytomegaly virus (CMV) with a particle diameter of 100 nm (inclusive envelope the virion measures 200 nm) belongs to the family of herpesviridae like Herpes 1 and Herpes 2. The transmission is effected via saliva and by long-term intimate contacts. The incubation time is 2-10 days for primary infections.
Cytomegaly appears often during the gravidity, and per year up to 5% of the pregnant women show clinical signs of the disease. In the early phase the illness frequently remains undetected, and the affected women themselves show no symptoms. When however newborns are infected (1% of the births), these show in 10% of the cases disease symptoms with late damages like retinitis, ulcera of the mucous membrane, viral pneumonia, meningitis, microencephaly, hydrocephalus and skin ulcerations. The incidence of women capable of childbearing is estimated to be 65%, so that an assessment of the immune status before pregnancy is mandatory. After a negative result, a control check is recommended in the 20th week of gestation.
Besides the symptomatic treatment a specific therapy with phosphonoformate and ganciclovir is possible. A vaccination does not exist, so that in the case of an infection only passive CMV immunoglobulins are administered.
Together with the differential assessment of the above mentioned symptoms, the diagnosis is performed clinically in tissue samples via the so-called "owl eyes". The following laboratory methods are available: CF and ELISA, determination of virus nucleic acid (PCR) as well as virus isolation (cell culture). Serologically, IgG and IgM antibodies can be detected and quantitated by the ELISA technique. Also the measurement of the avidity of the IgG molecules is appropriate