Cytomegalyiscausedbyaviralinfection,whichshowsaninapparentprogression,howeverleadstoserioussymptomswithimmune-compromisedpatientsandnewborns.
Thecytomegalyvirus(CMV)withaparticlediameterof100nm(inclusiveenvelopethevirionmeasures200nm)belongstothefamilyofherpesviridaelikeHerpes1andHerpes2.Thetransmissioniseffectedviasalivaandbylong-termintimatecontacts.Theincubationtimeis2-10daysforprimaryinfections.
CytomegalyappearsoftenduringthegrAvidity,andperyearupto5%ofthepregnantwomenshowclinicalsignsofthedisease.Intheearlyphasetheillnessfrequentlyremainsundetected,andtheaffectedwomenthemselvesshownosymptoms.Whenhowevernewbornsareinfected(1%ofthebirths),theseshowin10%ofthecasesdiseasesymptomswithlatedamageslikeretinitis,ulceraofthemucousmembrane,viralpneumonia,meningitis,microencephaly,hydrocephalusandskinulcerations.Theincidenceofwomencapableofchildbearingisestimatedtobe65%,sothatanassessmentoftheimmunestatusbeforepregnancyismandatory.Afteranegativeresult,acontrolcheckisrecommendedinthe20thweekofgestation.
BesidesthesymptomatictreatmentaspecifictherapywithphosphonoformateandganciclovirispossIBLe.Avaccinationdoesnotexist,sothatinthecaseofaninfectiononlypassiveCMVimmunoglobulinsareadmiNISTered.
Togetherwiththedifferentialassessmentoftheabovementionedsymptoms,thediagnosisisperformedclinicallyintissuesamplesviatheso-called“owleyes”.Thefollowinglaboratorymethodsareavailable:CFandELISA,determinationofvirusnucleicacid(PCR)aswellasvirusisolation(cellculture).SEROlogically,IgGandIgMantibodiescanbedetectedandquantitatedbytheELISAtechnique.AlsothemeasurementoftheavidityoftheIgGmoleculesisappropriate.