Cytomegalovirus

Worldwide spread DNA genomic virus which belongs to the family of Herpesviridae. The virus is the cause of cytomegalovirus infections.

HHV-5. Genome from dsDNA. The cytomegalovirus is the largest virus within the Herpesviridae, but morphologically it does not differ from the other members of this family.

The naked virion is 100 nm in size. With envelope the virus measures up to 200 nm.

Incubation period: 2-10 weeks for primary infections. S.u. Herpes viruses, human.

Different levels of infestation (Europe 50%, third countries > 90%) of the population. The virus has the ability to persist latently in the body. CMV is usually transmitted as droplet infection, but also as smear infection and during breastfeeding (most common prenatal infection).

• Extracutaneous manifestations: 99% of the initial infections are without or with only minor symptoms. The leading symptom is high fever, sometimes lasting for weeks, with typically elevated liver values in the laboratory. Life threatening complications such as myocarditis, thrombocytopenia or pneumonia are rare in immunocompetent patients. Severe courses are regularly observed in immunocompromised patients. HIV-infected patients with low CD4+ cell count often show CMV retinitis with acute risk of blindness. After bone marrow transplantation CMV pneumonia is frequent.
• Integument: Skin changes (see below cytomegaly): icterus, punctiform or extensive skin bleeding, maculopapular (mononucleosis-like exanthema, erythroderma, cytomegalovirus ulcer). see below cytomegalovirus infection

S.u. Cytomegalovirus infection.

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2. Cruysmans C et al (2016) Severe Skin Complications After Small Bowel Transplantation: Graft-Versus-Host Disease, DRESS, Virus, or Drug Toxicity? Transplantation: PubMed PMID: 26950725.
3. Ezzatzadegan Jahromi S et al (2016) A potential role for cytomegalovirus in a facial ulcer in a renal transplant recipient. Transpl Infect Dis 18:457-460.
4. Guo RF et al (2015) Cutaneous ulcer as leading symptom of systemic cytomegalovirus infection. Case Rep Infect Dis doi: 10.1155/2015/723962.
5. Neumann AB et al (2016) Cutaneous involvement by cytomegalovirus in a renal transplant recipient as an indicator of severe systemic infection. An Bras Dermatol 91:80-83.