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Symptoms of cytomegalovirus infection
Last reviewed: 17.10.2021
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Symptoms of cytomegalovirus infection in congenital children
If infection occurs in the early stages of pregnancy, fetal death and spontaneous miscarriage are possible, and teratogenic effects of cytomegalovirus (developmental defects) are not ruled out. There are microcephaly, microgyria, hydrocephalus, a violation of the architectonics of the substance of the brain with the development of oligophrenia. The defeat of the cardiovascular system is manifested by the non-separation of interventricular and interatrial septa, endocardial fibroelastosis, malformations of the aortic valves, pulmonary trunk. Described the malformations of the gastrointestinal tract, kidneys, lower extremities, lungs and other organs.
When infection in the late stages of pregnancy, developmental malformations usually do not happen. Cytomegalovirus infection in these cases manifests itself immediately after birth, the first signs of the disease may be jaundice, hepatolienal syndrome, lung damage, gastrointestinal tract, hemorrhagic manifestations. Especially typical triad of symptoms of cytomegalovirus infection: jaundice, hepatosplenomegaly and hemorrhagic purpura. In most cases, jaundice appears in the first 2 days and is severe. In all children, the urine becomes saturated as a result of an increase in the concentration of bile pigments and urobilin. Cal is partially discolored. The liver extends from under the edge of the edge arch to 3-7 cm, and the spleen - to 5-10 cm.
The hemorrhagic syndrome is represented by ecchymosis, petechiae on the skin, vomiting "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 pronounced. Body weight gain is slow, subsequently marking hypotrophy of II-III degree.
In the study of blood, hypochromic anemia with erythroblastosis, reticulocytosis, leukocytosis, moderate thrombocytopenia is revealed. In the blood serum, the bilirubin content is increased to high digits, with almost half the free fraction. The activity of ALT, ACT is increased 2-5 times, alkaline phosphatase - 2-3 times, total cholesterol, beta-lipoproteins are sharply increased. The level of total protein and albumins is decreased with a moderate increase in a- and y-globulins. The level of prothrombin in the midst of the disease may not differ from the norm, timole sample is increased slightly. When radiographing the skull, they sometimes detect microcephaly, calcifications and hydrocephalus.
Symptoms of cytomegalovirus infection in children of acquired form
The disease can be accompanied by an isolated lesion of salivary glands (usually parotid, less submandibular and sublingual) or with lesion of visceral organs. In contrast to congenital cytomegaly, the process relatively rarely becomes generalized, manifesting mainly mononucleoside-like syndrome. In other cases, the clinical picture is dominated by the symptoms of cytomegalovirus infection in the form of interstitial pneumonia (dyspnea, cyanosis, persistent pertussis-like cough, etc.), gastrointestinal disorders (vomiting, frequent stools), impaired hepatic function (jaundice, dark urine, in the serum of the level of conjugated bilirubin, activity of alkaline phosphatase, ALT, ACT), changes in urine (protein, epithelial cells, cytomegaly). Diagnosis, as a rule, causes great difficulties. Such patients are consistently examined for sepsis, toxoplasmosis, yersiniosis, typhoid fever, etc.