Cytomegalovirus: what is it in children, symptoms and treatment of infection as manifested, complications, consequences, analysis, diagnosis

One of the most common childhood viruses - cytomegalovirus, which belongs to the family of herpes viruses. It causes cytomegalovirus infection.

What is cytomegalovirus in a child

The literal translation of his name means "giant cell", suggesting the virus properties change structure of certain cells of the body, which leads to an accumulation of fluid in them and increase their sizes.

Once once in the body, it stays there for life. However, in healthy children, its presence does not manifest itself, but only limited to carriage of the virus. The disease occurs with equal frequency at different ages. Usually, it is easy, but if reduction of immunity, symptoms progresses, and can lead to serious complications.

Infection refers to the "opportunistic" diseases, as shown only on the background of immunodeficiency. In most cases, the disease AIDS also detect cytomegalovirus infection. It often occurs during the physiological decline of immunity that occurs in pregnant women, in people after chemotherapy of malignant tumors.

The virus is present in body fluids: saliva, urine, blood, tears. Due to the high concentration in the saliva, the disease is also called "kissing disease".

types of diseases

Cytomegalovirus in children differs by 2 main types:

1. congenital cytomegalovirus - occur after intrauterine infection. It comes through the placenta of women contracting it during pregnancy. During this period, she has no antibodies to the pathogen, so it can easily penetrate to the fetus. This form of disease dangerous its consequences which can occur even 10 years after the birth of a child.

Distinguish local and generalized forms of the disease. And also it is isolated three stages: acute, subacute and chronic. If fetal infection occurs in the early stages, then there are significant defects or fetal death in utero.

Acute and subacute stage are before delivery, so the baby is born already with chronic cytomegaly. If infection has occurred in the last terms of pregnancy or during labor is, that in the newborn with symptoms of acute stage of the disease. In this case, the disease occurs in a generalized form and manifests clinic hemolytic jaundice babies.

2. acquired cytomegalovirus - occurs after birth. This usually occurs during the school attendance or kindergarten. Children infected with coughing, sneezing, using common toys, close contact. You can also send the virus in breast milk during lactation or after transfusion of blood products.

In the case of Acquired cytomegalovirus infection often takes place in a local form with lymph node and salivary glands. Once infected, the child to isolate the virus for 2-3 years.

Symptoms of congenital cytomegalovirus

For congenital cytomegalovirus may pass without symptoms and only become apparent in a few years.

But if the body is weakened, the disease picture progresses from the early terms and it is characterized by such symptoms:

• baby lethargy, poor appetite;
• fever;
• slow weight gain;
• restless sleep;
• violation stool (feces discoloration, constipation);
• hepatosplenomegaly;
• body rash, jaundice of the skin (due to lesions of the bile capillaries);
• thrombocytopenic purpura, nose, navel bleeding, melena (manifestations of hemorrhagic syndrome);
• underdevelopment of the newborn;
• hearing loss, vision;
• seizures, neurological abnormalities;
• vomiting.

Symptoms of acquired cytomegalovirus

Cytomegalovirus in children over their similar to SARS, the common cold, mononucleosis and other illnesses, so recognize it at an early stage is difficult.

are typical of its symptoms are:

• constant fatigue, drowsiness, apathy;
• poor appetite;
• intoxication (fever, headache, aching muscles);
• inflammation of the salivary glands;
• violation stool (diarrhea alternating with constipation);
• abdominal pain;
• redness of the throat, accompanied by pain in it;
• increased tonsils and cervical lymph nodes;
• chills, fever.

The severity of the clinical picture depends on the nature of the infection, the state of health of the child and his or her age.

The incubation period lasts for more than a month, and during this time the patient can infect others, as the causative agent of active released at this time.

Symptoms of the disease lasts from 2 weeks to several months, after which they could vanish into thin air.

Possible consequences and complications

Cytomegaly can entail many consequences in children, the appearance of which depends on its shape.

congenital form

The acquired form

CNS side effects: Microcephaly, hydrocephalus, encephalitis, strabismus, nystagmus, facial asymmetry, hypotension, muscle cramps. Pneumonia with involvement in the process of the bronchi and bronchioles, which are not amenable to conventional therapies. Renal, often with nephrotic syndrome. Blindness - one of the most common complications is caused by atrophy of the optic nerve. Deafness, which can progress to 3-4 years.

pleurisy - in connection with the involvement in the process of bacterial infection. pneumonia - often with very severe stroke. Arthritis - usually affects large joints, but it is possible to involve in the process and small joints. Myocarditis - held in violation of rhythm and conduction. Encephalitis - one of the most serious consequences. Nephritis - renal affects various structures.

The most serious disturbances arise in congenital form. The prognosis for children with this option unfavorable. Mortality reached 80% of the patients. Surviving children fall behind in physical and mental development of their peers. And only about 10% of infected infants observed a favorable course of the disease.

Complications acquired forms arise from the merger of bacterial flora, which is distributed throughout the the body and affects various organs: the eyes, lungs, heart, kidneys, adrenals, pancreas, spleen, stomach, intestines.

It is also possible inflammation of the deep structures of the brain, causing significant central nervous system disorders, in some cases, paralysis, and sometimes - even death. But, in general, the prognosis for patients with the acquired form of congenital favorable.

diagnosis of the disease

Cytomegalovirus is easy to diagnose in children, but on the basis of symptoms, those of other diseases, it reveals, usually in the later stages. The first diagnostic criterion for distinguishing cytomegalovirus infection, is the duration of symptoms. They are held much longer than other diseases.

It should be a differential diagnosis with acute respiratory viral infection, mononucleosis, tonsillitis, hepatitis, which requires appointment a series of tests: a general analysis of blood and urine tests, blood chemistry, blood clotting, seeding with nasopharyngeal on flora.

instrumental methods of research are also recommended:

• cardiogram;
• Ultrasound of the abdomen, kidneys, liver;
• fibrogastroduodenoscopy;
• electroencephalography.

But residual confirm the diagnosis is possible only after carrying out laboratory tests with the determination of the virus in different organs and tissues of the body that need to be repeated 2-3 times. For analysis using urine, blood, saliva, cerebrospinal fluid.

There are some laboratory research methods:

• Molecular biological analysis (PCR) - it is the most informative method of diagnosis as it allows not only to identify the DNA of the virus, but its activity in the body of the child. But, due to the cost of such an analysis, it is rarely used.
• virological - is based on the determination of a specific virus.
• Serological (ELISA Method) - analysis, which is used most frequently. Its essence is to identify the antibodies that are produced in response to the disease.

The research results can be revealed IgM and IgG:

• If IgM positive - it testifies to the acute phase of the disease or recent infection and always confirmed activity of the process.
• positive IgG - the presence of antibodies that appear after a month after an illness. It is not a marker for the disease, but only confirms the fact of transferring it in the past.
• If a positive IgM and IgG negative - this result meets fresh infection, as IgG has not had time to develop.
• Positive IgM and IgG - worsening of the disease.
• Negative IgM and IgG positive - in this case, the child remains almost healthy, but it is a carrier of the virus.

The diagnosis plays an important role consultation narrow specialists: ENT, ophthalmology, infectious disease specialist, endocrinologist, neurologist. It is necessary to exclude co-infection and early detection of complications.

treatment with drugs

Treatment of CMV infection must be complex and consist of antiviral drugs and drugs to enhance immunity.

Antiviral Medications for cytomegalovirus:

• Ganciclovir (Cymevene) - the most effective drug etiotropic. It is assigned by 5.10 mg / kg / day intravenously. In addition to its use, Cymevene has properties neurotoxicity, so can provoke seizures. Its side effect is also a thrombocytopenic reaction.
• foscarnet - ganciclovir alternative embodiment, the use of which without any reason is impossible (intolerance, allergic reactions). Assign it at a dosage of 60 mg / kg / day intravenously. Side effects of foscarnet identical Tsimevenu.
• valacyclovir - it has good bioavailability and tolerability. 2-3 grams per day it is sufficient for the desired effect.
• Denavir and Famvir - New tools on the market that are well established in the treatment of ordinary herpes 1 and 2 types. But in the treatment of cytomegalovirus infection are still not well understood.
• acyclovir - prescribed only in case of impossibility of appointment of other drugs as effectively his treatment of large doses are needed, which have a negative effect on the body as a whole and tolerability the drug.

In recent years, cases of the disease with mutations in the genome. In this connection there pathogen resistance to treatment with antiviral agents. Often marked by a reactivation of the virus after the end of therapy.

To avoid this, we need drugs that affect the defective part of immunity. In most cases, such a link is the lack of cellular mechanisms or the production of interferon.

Medications for enhancing immunity:

• Inosine derivatives (Isoprinosine / Groprinozin) - stimulate the synthesis of prostaglandins and interleukins than provide an antiviral effect. But should not be used together with anti-inflammatory drugs due to a decrease of therapeutic effect
• Thymosin, Zadaxin - thymomimetic synthetic origin. They are used for immunodeficiency states with damage to the cellular level.
• Imunofan - it has the ability to stimulate the function of T-lymphocytes, without involving prostoglandinovye mechanisms. This makes it possible to avoid sharpening of inflammation and allergic reactions. There is evidence that Imunofan can stimulate the production of interferon, and to reduce the concentration of immunoglobulin E. In comparison with other thymomimetic, it significantly careless. Side properties of its use are rare and mild, so it can be used in the treatment of pregnant women.
• Amiksin, Neovir, TSikloferon - stimulants synthesis of endogenous interferon. Well established in the joint application with antiviral medicines. Subsequently the reception of the group provides the patient from the reactivation of the virus.
• Kagocel - interferon inducer, which is even a one-time application stimulates the production of antiviral proteins for 6-8 days. It is prescribed for treatment and prevention of disease. For treatment use "cumulative" method of reception 5-6 days without a break. For preventing drug use "pulsovym" method (one process per week).
• Nature (leukocyte) interferon rarely administered because of the difficulty of its synthesis and insufficient degree of purification. It has antiviral and immunostimulatory influence, but in the treatment of cytomegalovirus is poorly understood.
• Protivotsitomegalovirusnye specific immunoglobulins - accept only with severe immunodeficiency (HIV, AIDS), together with nucleoside antiviral agents, or if you can not causal and immunostimulatory therapy pregnant.

Despite the constant improvement of medicines and synthesize their new species, the development of treatment regimens cytomegalovirus infection to date, remains relevant.

Folk remedies

Cytomegalovirus in children has long been treated with folk remedies. Ginseng strengthens the immune system, echinacea, lemongrass, licorice root, raspberry, honey.

The most effective recipes using plants in the treatment of disease there are:

• A decoction of the rowan. Rowan possesses immunostimulating, choleretic, diuretic properties, which arise due to its composition. It combines complex amino acids, essential oils, as well as succinic acid, malic acid, tartaric acid and sorbitol.
• To prepare the broth, you need 1 tbsp. l. berries grind and brew in 1 liter of water.
• Infuse a decoction must not less than 2 hours, and then taken before each meal.
• therapy - 2 weeks, which is worth repeating again for 2-3 months.
• Infusion of celandine with dandelions.
• Celandine, dandelion root and milk thistle dry, take them equal parts, chop and mix.
• 1 tbsp. l. the mixture is poured 0.5 liters of boiling water.
• Boiled 5-10 min., Then filtered and applied 3 times a day before meals.
• Healing infusion of wild cherry.
• It is mixed herb wormwood with cherry fruit at a ratio of 3: 4 and add 3 parts of liquorice and blackcurrant leaves and 2 parts plantain, and the same amount of thyme.
• Plant leaves and dry mix.
• In 0.5 l of boiling water to brew 2 tbsp. l. prepared mixture.
• It is taken 2-3 times a day with 50 ml.
• Treatment was continued for 3 weeks.
• Infusion with echinacea.
• 1 tbsp. l. Echinacea poured 0.5 liters of water and insist 12 hours.
• For 3-4 weeks, the infusion should be taken daily for 30 minutes. before a meal. It is also possible to use echinacea in pure form by a few drops adhering to the same scheme.

Prevent the recurrence of the infection may be hardening, and regular physical activity. In the treatment of cytomegalovirus infection is positive for the child is also affected by a massage, particularly point that tones the autonomic nervous system.

Due to the sensitivity of the virus to a high temperature environment, recommended visiting baths, saunas. An important step is a rational balanced diet, sufficient amount of vitamins and personal hygiene.

Registration of the article: Vladimir the Great

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