Cytomegalovirus infection is a sexually transmitted disease caused by cytomegalovirus (cmv). Cytomegalovirus is a DNA virus. The characteristic lesions are enlarged infected cells with eosinophilic and basophilic inclusions in the nucleus and cytoplasm, respectively.CMV infection is distributed worldwide and humans are the only host of CMV. The rate of infection varies by country and economic status. There is a close relationship between CMV infection and immune function in adults. How to check for increased cellular infection? I. Symptoms 1. Congenital infection Congenitally infected infants may show only cytomegalovirus urine and otherwise have no abnormalities. In severe cases CMV infection can cause miscarriage, stalled labor or death after birth due to bleeding, anemia or extensive liver or central nervous system damage. Like hepatitis B and herpes simplex virus, cytomegalovirus (CMV for short) can be transmitted from pregnant women to their fetuses via the placenta. It occurs after initial maternal infection or reactivation of a previous infection, with the former having a higher risk of serious fetal pathology than the latter. The earlier the infection is acquired in pregnancy, the more severe the fetal pathology. CMV infection during pregnancy is often mild or asymptomatic and therefore difficult to detect prenatally. Infected embryonic leukocytes spread throughout the body and invade various organs of the fetus, leading to developmental abnormalities. Congenital CMV infection can cause prematurity in newborns. 90% of newborns are asymptomatic at birth, while a few may develop months or years later. 5% develop typical symptoms of giant cell inclusion disease at birth or shortly after birth, including low birth weight, microcephaly, retinal chorioretinitis, jaundice, hepatosplenomegaly, interstitial pneumonia, convulsions, and reduced platelets. CMV is the most common virus causing mental deficiency and can have permanent brain damage, which can also manifest as intellectual or hearing impairment. 2. Acquired infections in healthy individuals Acquired infections in healthy individuals, whether acquired after birth or at any time in their lives, are often asymptomatic. Cytomegalovirus mononucleosis or cytomegalovirus hepatitis can be an acute febrile illness. CMV infection in infants is acquired during delivery through the birth canal in the presence of CMV, or after birth through breast milk with the virus. Most of the cases develop within 2-4 months after birth, with mild symptoms, mostly subclinical, but also with moderate jaundice, hepatosplenomegaly, liver function abnormalities, lymph node enlargement, interstitial pneumonia, and rash. CMV can be transmitted by contaminated hands and toys through saliva and urine when children are in close contact with each other in group life such as nurseries and kindergartens. The clinical presentation is similar to that of adult-acquired infection, but the swelling of cervical lymph nodes is greater than that of adults. Healthy adults can acquire the infection from children, or from sexual intercourse, and people with promiscuous sex lives are more frequently infected. The clinical presentation is mainly a group of mononucleosis with a negative heterophilic agglutination test. Peripheral blood picture leukocytosis, predominantly lymphocytes, with abnormal lymphocytes present. 3. Infection in immunodeficient individuals CMV in immunosuppressed patients is the main cause of morbidity and mortality in this group of patients. It develops due to reactivation of latent virus and can involve the lung, gastrointestinal tract or central nervous system. In the late stages of AIDS, CMV infection often causes retinitis and ulcerative disease of the colon or esophagus. CMV infection in people on maintenance immunosuppressive therapy such as malignancy, connective tissue disease and organ transplant recipients can be caused by reactivation of latent virus (latent in the host, blood products or transplanted organs). Blood transfusions, especially white blood cell transfusions, bone marrow transplants, and kidney transplants, are susceptible to CMV infection, and AIDS has an extremely high rate of CMV infection. Post-transfusion syndrome can occur 2 to 4 weeks after transfusion of fresh blood containing CMV and is characterized by fever lasting 2 to 3 weeks with varying degrees of hepatitis, splenomegaly and characteristic atypical lymphocytosis, similar to infectious mononucleosis. The disease is similar to spontaneous CMV mononucleosis, but splenomegaly is more common. CMV infection in organ transplant recipients often occurs within 1-2 months after transplantation, often in a subclinical form, but if it develops, the clinical manifestations are numerous and severe, most commonly fever and interstitial pneumonia, but also hepatitis, retinitis and gastrointestinal symptoms. Interstitial pneumonia is a common cause of death in bone marrow transplant and kidney transplant patients. It starts slowly, and patients have shortness of breath, dry cough, cyanosis, and wet rales can be heard under both lungs. In mild cases, there may be no obvious symptoms, and inflammation of the interstitial space on both sides is found on chest radiographs, which heals spontaneously after 2-3 weeks. CMV infection itself can also cause immunosuppression, making it susceptible to infection and dissemination of other opportunistic pathogens such as bacteria, fungi, Pneumocystis carinii and herpes simplex virus. In addition, CMV is associated with Kaposi’s sarcoma and malignancy, which can occur in the prostate, rectum and cervix. Diagnosis Clinical diagnosis of CMV infection is difficult, but the following conditions may be the cause of the disease, and then combined with pathogenic and serologic tests for a definitive diagnosis: 1. Any infant born prematurely, with congenital malformations and malnutrition, or with unexplained jaundice, hepatosplenomegaly, purpura, rhinorrhea, microcephaly and brain and eye damage in the neonatal period. 2, Children or adults with mononucleosis syndrome group with negative heterophilic agglutination test. 3, Immunocompromised or bone marrow, kidney transplant recipients, etc. with fever and interstitial pneumonia who have failed antibiotic treatment.