Symptoms of cytomegalovirus infection

Symptoms of cytomegalovirus infection in children of congenital form

If infection occurs in the early stages of pregnancy, fetal death and spontaneous abortion are possible, and the teratogenic effect of cytomegalovirus (malformations) cannot be ruled out. There are microcephaly, microgyria, hydrocephaly, disruption of the architectonics of the brain tissue with the development of oligophrenia. Damage to the cardiovascular system is manifested by non-closure of the interventricular and interatrial septa, endocardial fibroelastosis, malformations of the aortic valves, pulmonary trunk. Malformations of the gastrointestinal tract, kidneys, lower limbs, lungs and other organs are described.

When infected in late pregnancy, there are usually no malformations. Cytomegalovirus infection in these cases manifests itself immediately after birth, the first signs of the disease may be jaundice, hepatosplenomegaly, lung damage, gastrointestinal tract, hemorrhagic manifestations. The triad of symptoms of cytomegalovirus infection is especially characteristic: jaundice, hepatosplenomegaly and hemorrhagic purpura. In most cases, jaundice appears in the first 2 days and is pronounced. In all children, urine becomes saturated as a result of an increase in the concentration of bile pigments and urobilin. Feces are partially discolored. The liver protrudes from under the edge of the costal arch by 3-7 cm, and the spleen - by 5-10 cm.

Hemorrhagic syndrome is represented by ecchymosis, petechiae on the skin, and vomiting of "coffee grounds". Sometimes the symptoms of cytomegalovirus infection in the form of hemorrhagic manifestations come to the fore, and jaundice appears later and is not clearly expressed. The increase in body weight is slow, subsequently hypotrophy of II-III degree is noted.

Blood tests reveal hypochromic anemia with erythroblastosis, reticulocytosis, leukocytosis, and moderate thrombocytopenia. Serum bilirubin levels are high, with free fraction accounting for almost half. ALT and AST activity is increased 2-5 times, alkaline phosphatase activity is increased 2-3 times, total cholesterol and beta-lipoproteins are sharply increased. Total protein and albumin levels are decreased with a moderate increase in a- and y-globulins. Prothrombin levels at the height of the disease may not differ from the norm, and the thymol test is slightly elevated. Skull radiography sometimes reveals microcephaly, calcifications, and hydrocephalus.

Symptoms of cytomegalovirus infection in children of the acquired form

The disease may be accompanied by isolated damage to the salivary glands (usually parotid, less often submandibular and sublingual) or with damage to the visceral organs. Unlike congenital cytomegaly, the process rarely becomes generalized, manifesting itself mainly as a mononucleosis-like syndrome. In other cases, the clinical picture is dominated by symptoms of cytomegalovirus infection in the form of interstitial pneumonia (shortness of breath, cyanosis, persistent whooping cough-like cough, etc.), gastrointestinal disorders (vomiting, increased stool frequency), liver dysfunction (jaundice, dark urine, increased serum levels of conjugated bilirubin, alkaline phosphatase activity, ALT, AST), changes in urine (protein, epithelial cells, cytomegalosides) are also possible. Diagnostics, as a rule, causes great difficulties. Such patients are sequentially examined for sepsis, toxoplasmosis, yersiniosis, typhoid fever, etc.