Last Updated: 2019-08-27
Cytomegalievirus, CMV, HCMV, human herpesvirus 5, HHV-5
Viral infectious disease with human herpes virus 5.
Worldwide, about 50-80% of the population is infected.
- Transmission through droplet, smear infections, transplants and transfusions.
- After the virus has settled in the mucosa of the oropharynx, it replicates the virus and spreads via leukocytes.
- CMV infection is usually asymptomatic.
- Can lead to rejection reactions after bone marrow or organ transplants.
- Intrauterine infections can lead to microcephaly, cataract, optic atrophy and intracerebral calcifications.
- Mononucleosis-like clinic.
- PCR Viral.
- CMV chorioretinitis
- Skin ulceration in HIV patients.
- In case of eye infestation, ophthalmological consil.
- Ganciclovir (Cymevene®) intravenously, initial: (over 1h) 5 mg/kg bw 2x daily for 2-3 weeks. Maintenance therapy: 6mg/kg bw/week.
- Foscarnet (Foscavir®) intravenously, initial: 60 mg/kg bw 3x daily for 2-3 weeks. Maintenance therapy: 7x/week 90-120 mg/kg bw.
- For immunosuppression and acyclovir resistance: valganciclovir (Valganciclovir®) p.o., initial: 900 mg 2x daily for 21 days, maintenance therapy: 1x 900 mg p.o./d.
- Cidofovir: no longer available
- Specific immunoglobulins:
- for CMV prophylaxis in immunosuppressive therapy.
- Human cytomegaly immunoglobulin
- Cytotect® (1000 U/ 5000 U) intravenously
- Adults: 50 I/kg over 1-4 hours
- Children: 50-1000 I/kg over 1-4 hours
- Running speed: initial 0.08 ml/kg/h, after 10-15 minutes slow increase to 0.8 ml/kg/h
- Contraindication: IgA deficiency with IGA antibodies.
- Congenital infection:
- Cymeven® intravenously 6 mg/kg bw every 12 hours for 6 weeks.
- Efficient vaccines are not available.
- Cave! Ganciclovir is bone market toxic, therefore cooperation with special centres is recommended
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