Cytomegalovirus isolation in women. Main symptoms and modern treatment of cytomegalovirus in women. How to determine the duration of infection

Something between a virus and a bacterium. It develops in the cells of the body, parasitizing them and remaining in a state of “hibernation” until a certain moment. CMV begins to actively reproduce only when favorable conditions arise in the form of a sharp drop in the level of immunity. The symptoms of the disease are sluggish, diagnosis is difficult. The fact is that the symptoms of CMV overlap with some colds, so identifying the virus takes a long time and requires a number of studies, some of which are very complex. By what signs can cytomegalovirus be detected and what consequences does this disease lead to?

Signs of CMV vary among different sexes and ages. This is explained by differences in metabolism and the structure of the genital organs, as well as the hormonal characteristics of groups of patients. In the case of representatives of the fairer sex, the symptoms are very similar to those of respiratory diseases, so identifying the virus even in its later stages is difficult without additional tests.

The disease begins from the latent stage. There are no symptoms in 95% of cases, the microorganism “sleeps” in the cells, multiplying moderately. In this situation, the woman is a hidden carrier, but she herself is not yet suffering. As soon as the body stops coping with CMV on its own (immune way), the disease begins to develop. At this moment the first signs appear:

• inflammation and enlargement of lymph nodes (the main first sign);
• weakness;
• chills;
• chronic fatigue;
• irritability.

Sometimes this is accompanied by joint pain and muscle aches. There are no sexual characteristics yet, they will appear later. The subtlety of this period lies in the fact that treatment at this time is usually the most effective and fastest, but it is rare that a woman goes to the hospital for a comprehensive examination if such symptoms occur. So it turns out that therapy begins only when CMV enters the active phase.

Further signs of the disease are rarely detected by the patient herself; they are identified through a gynecological examination:

• vaginitis;
• endometritis;
• oophoritis;
• cervical erosion.

The patient, of course, can herself identify these ailments that are a consequence of CMV, but only by indirect signs, for example, vaginal discharge and pain during urination and sexual intercourse. The diseases considered cannot be called full-fledged signs of “our” virus, these are more consequences, but they can be used to identify cytomegalovirus.

Diagnostics

The use of one diagnostic method is unlikely to bring a completely reliable result - there are many varieties of CMV, each of them has its own characteristic DNA features. For diagnosis, it is necessary to use the patient’s biomaterial; simply taking an anamnesis does not bring results. Doctors use as a sample:

• saliva;
• urine;
• blood;
• breast milk;
• discharge from the genitals;
• secretion of the lungs.

In some cases, tissue obtained by biopsy is used. It is done rarely and only in cases where there is suspicion of cancer. In other situations, a biopsy is excluded due to its danger to the patient’s body.

Blood smear microscopy is available to every patient, it is inexpensive and can be done quickly. But the accuracy of this method does not exceed 70%, so you cannot limit yourself to only these data when diagnosing CMV.

The first thing the doctor advises the patient to do is:

1. Get tested for antibodies to CMV. Moreover, if IgG antibodies are detected, then the person is infected with the virus, but the active phase of the disease is not observed, the microorganism sits quietly in its cage, not manifesting itself in any way. This cannot be said that this is good, but almost half of the world’s population is carriers of this microbe, and the presence of antibodies indicates that the body is fighting, and successfully, it has immunity to CMV.
2. Diagnostic titer of CMV (IgG value), at which the patient can be considered sick is 1:100. If the value is less than 60, then doctors do not attach any significance to it; such an indicator can only indicate a previously suffered disease. If the titer value exceeds 200, then we can talk about a clinically developing form of the disease; this is a bad indicator. But there is no need to declare panic; the presence of an infection in the blood does not always pose a danger to a woman; much depends on her state of health and the chosen therapeutic strategy.

In addition to testing antibodies to CMV, doctors use the following diagnostic methods:

• PCR. It allows you to detect the DNA of an infectious agent, but is not highly accurate. However, in most cases, these results are enough to choose a treatment path.
• Bioseeding. In an artificial environment, specialists grow a sample of the virus strain, which is studied in detail. The most accurate, but also the most expensive method.
• Virus isolation. It is comparable in accuracy to bioseeding; it takes the same amount of time, but costs slightly less (not in all clinics).

The sooner diagnosis is started, the greater the chance of suppressing an unpleasant disease.

Treatment

It is impossible to completely “remove” the virus from the body; medicine has not yet developed medications that can kill the entire, so to speak, colony of microorganisms. Modern drugs can only limit the activity of microbes, reduce their ability to reproduce and transfer the disease to the latent phase. The basis of CMV therapy is to take antibiotics:

• Foxarnet;
(costs from 110 to 3,705 rubles);
• Ganciclovir (about 1,700 rubles);
• Valganciclovir (about 30,000 rubles).

You cannot choose a drug yourself, much less determine a regimen for taking it. At best, this approach to treatment simply will not bring results.

In addition to taking antibacterial medications, the ability of the immune system to resist infection should be increased. For this, doctors prescribe vitamin complexes and immunomodulators:

• B vitamins;
• magnesium;
• antioxidants.

Neuroprotectors will also not hurt, especially when it comes to fighting CMV at a late stage, when the infection affects the central nervous system and other vital systems of the body.

Traditional treatment for the virus does not stand aside either. The most commonly used herbal decoctions are:

• chamomile;
• lemon balm;
• juniper;
• rosehip;
• licorice root.

They are easy to get; such preparations are sold in many pharmacies. These folk remedies not only suppress the activity of the virus, but also strengthen the immune system. Without developed body defenses, the fight against CMV is practically pointless, because medications only help in the fight against microbes, but do not provide it with a 100% guarantee, regardless of the patient’s lifestyle and general state of health.

Danger and complications of CMV

For women, CMV is especially dangerous. The reason for this lies in the structural features of the reproductive system. Over time, the virus causes inflammation of the uterus, gonads, ovaries, etc. By the way, this provokes odorous vaginal discharge, which is an additional symptom of the disease. If urgent measures are not taken, the disease will spread throughout the entire body, affecting:

• intestines;
• heart and blood vessels;
• eyes and hearing organs.

As for the birth of a child, a woman can relax a little. If in men CMV almost inevitably affects the quality of sperm, which can lead to deformities in the unborn baby, then an “infectious” mother transmits the infection to the fetus only in 20-25% of cases. Moreover, if the disease is treated in time, the unpleasant consequences of CMV can be easily avoided.

Neglected cytomegalovirus can lead to infertility. This happens only in the case of a complete lack of therapy and a very weak immune system. Risks are also increased by associated diseases, such as AIDS, oncology and problems with the genitourinary system.

Prevention of CMV

Remember above we talked about the low probability of transmission of infection from mother to fetus? So, if this does happen, the consequences will be dire, especially for the unborn child. The conclusion is simple - you need to be regularly examined during pregnancy, and if CMV is detected, do not refuse treatment. But not only the period of bearing a child is dangerous; preventive measures must be carried out constantly:

• avoid unprotected sexual intercourse;
• Shower regularly and wash your hands, especially before eating and after contact with contaminated objects and surfaces;
• play sports;
• establish the correct daily routine;
• add more foods rich in vitamins to your diet, such as vegetables and fruits (this is necessary to strengthen the immune system);
• Do not use other people's laundry or dirty kitchen utensils.

Following these simple rules can really save you from CMV. Those women who do not avoid prevention very rarely encounter the virus.

You can also get acquainted with the opinion of a specialist by watching this video about what CMV is in women, the main causes and symptoms, as well as what treatment methods are available.

Cytomegalovirus is considered a common infection today. Symptoms in women can occur either mildly or completely absent, which can be explained by the latent course of the disease. If a person's immune system is strong enough, infectious agents do not pose a threat to the body. Otherwise, especially if you have an existing immunodeficiency or after a transplant, cytomegalovirus can cause dangerous complications.

Cytomegalovirus in women, when it enters the body, causes a chronic infectious disease. For the most part, there are no manifestations of infection as such, but cases when clearly expressed symptoms occur are not uncommon. The main reason for foreign agents entering a woman’s body is a weakened immune system. At the same time, it is no longer able to fight penetrating infections, allowing them to gain a foothold in internal organs and systems. Unfortunately, people of any age are susceptible to the disease.

The initial entry of the virus into a woman’s body occurs from the direct carrier of this infection. A secondary disease is caused by exposure to a certain external or internal factor, which negatively affects the protective function of the immune system. The root causes can be called:

• transmission of infection to a child during labor or during the prenatal period;
• the virus enters the body when a sick person coughs, sneezes or kisses;
• infection as a result of transfusion of contaminated blood to a healthy person;
• sexual intercourse with a sick partner is another reason for transmitting the infection.

An active course of cytomegalovirus infection can be caused by such provoking factors as the concomitant development of a cancerous tumor, HIV infection or AIDS, and pathologies of the digestive tract. Antitumor drugs and antidepressants that a person takes can also “awaken” the virus.

Symptoms of acute disease

CMV (cytomegalovirus infection) is accompanied by symptoms that vary from person to person depending on the form of the disease. In most cases, a latent course is diagnosed, in which clearly expressed symptoms do not appear until exposure to a provoking factor. In this case, an acute form of the disease occurs. Some people experience severe damage to internal organs, which characterizes a generalized form of pathology.

The acute form of cytomegalovirus disease has similarities with infectious mononucleosis. Its onset is abrupt, with a rise in general temperature and febrile syndrome. In addition to these symptoms, the first signs of pathology include damage to the lymph nodes, during which they increase in size. Their pain, increased softness and elasticity are also noted.

At stage 1 of the development of acute cytomegalovirus infection, the cervical lymph nodes are involved in the lesion. Following them, the submandibular, axillary, and inguinal areas increase. It is lymphadenopathy that is the first sign of the disease and the last to disappear. Other symptoms of this condition include headache, general malaise, hepatomegaly (an increase in the size of an organ such as the liver), and atypical mononuclear cells in the blood.

The main difference between cytomegalovirus infection and mononucleosis is the absence of sore throat in the first case. The occipital lymph nodes and spleen are also rarely enlarged.

Symptoms of a generalized form of the disease

This form of the disease occurs quite rarely, but with the development of severe symptoms. Basically, generalized cytomegalovirus infection in women occurs against the background of immunodeficiency or another infection. In the first case, the preceding factor may be chemotherapy or radiotherapy, and in the second, HIV infection. The generalized form of the disease can occur together with damage to internal organs, blood vessels, nerves, and salivary glands.

Development of cytomegalovirus hepatitis and pneumonia

Hepatitis due to cytomegalovirus is accompanied by the involvement of organ cells and blood vessels in the pathological process. In this case, the development of inflammatory infiltration and necrosis occurs. Dead cells slough off and invade the bile duct, clogging it and causing stagnation. As a result, jaundice occurs, the main symptom of which is yellowness of the skin. General malaise, nausea and vomiting also occur.

At the beginning of the development of a generalized cytomegalovirus infection, interstitial pneumonia occurs, which is accompanied by damage not to the alveoli, but to their walls, capillaries and tissue around the vessels. Treatment of this type of pneumonia is difficult, which explains its long course. In some cases, bacterial infections are associated with the following symptoms: a significant increase in general temperature, febrile syndrome, cough with sputum, and a feeling of shortness of breath.

Development of cytomegalovirus retinitis and sialadenitis

A disease such as retinitis is accompanied by damage to the retina. Both eyes are involved in the pathological process. Retinitis occurs with the following symptoms: photophobia, blurred vision and goosebumps.

With sialadenitis, the salivary glands are affected, especially the parotid glands. In this case, there is an increase in general temperature, the occurrence of a shooting pain syndrome in the affected area, a decrease in salivation and dryness in the oral cavity.

Development of cytomegalovirus nephritis and diseases of the reproductive system

The inflammatory process in the kidneys develops in such areas of the organ as the tubules, capsule, and glomeruli. In addition to the kidneys, the ureters and bladder may be involved. Renal failure develops quite quickly, which is accompanied by the appearance of sediment in the urine, including epithelium and cytomegalovirus cells.

It is possible to develop cervicitis, endometritis, salpingitis - those pathologies that are chronic. In this case, a symptom occurs such as periodic, unexpressed pain in the lower abdomen, which manifests itself during urination and during sexual intercourse.

Features of the course of cytomegalovirus infection in women with AIDS

According to numerous studies, 9 out of 10 women suffering from acquired immunodeficiency syndrome are also infected with cytomegalovirus. Such patients often suffer from bilateral pneumonia, which occurs in conjunction with damage to the lung tissue. This concomitant disease is characterized by a protracted course with the occurrence of a painful cough and shortness of breath. Another symptom of cytomegalovirus in women suffering from AIDS is encephalitis, the complications of which are dementia, decreased memory and attention.

The nervous system is also involved. Polyradiculopathy often develops, a disease characterized by damage to the nerve roots, general malaise and pain in the lower extremities. Cytomegalovirus infection in women with AIDS also occurs with the involvement of such organs in the pathological process as:

• kidneys, with subsequent development of acute nephritis, etc.;
• liver, with the occurrence of hepatitis, jaundice, liver failure, etc.;
• pancreas, with the development of pancreatitis, etc.;
• eyes, with the occurrence of retinitis, retinopathy, etc.;
• organs of the genitourinary system, with the further development of cancer of the cervix, endometrium, etc.

The treatment regimen for cytomegalovirus in such cases is determined by the attending physician. Often it is cytomegalovirus infection that occurs in women with AIDS that is the cause of death.

Treatment

Treatment of cytomegalovirus in women, first of all, consists of taking antiviral chemotherapy drugs, the active components of which help to inhibit the DNA polymerase of the virus.

Chemotherapy is prescribed, as a rule, if the disease occurs in a generalized form, when the retina or lungs are involved in the pathological process. Such products have increased toxicity, which does not allow their use during pregnancy. The effect of chemotherapy drugs on the human body causes a negative effect on an organ such as the kidneys.

Contraindications to the use of chemotherapeutic agents are: low hemoglobin (less than 80 g/l) and platelet level (less than 250 thousand * 10¹² g/l), the development of severe renal failure. Side effects may also occur, for example, such as impaired functioning of the liver, kidneys, seizures, candidiasis, ataxia.

Other drugs used in the treatment of cytomegalovirus infection are interferons. During the life of such a virus, leukocytes in the blood weakly produce natural interferon, which is the reason for its replenishment with the help of drugs. The most common of these are: Viferon, Cycloferon, Genferon. The advantage of such drugs is the limited number of side effects.

Another drug to eliminate cytomegalovirus infection is the hyperimmune human immunoglobulin Cytotect, which contains antibodies to the virus. The drug can be used even during pregnancy. Despite such a great effectiveness of the drug, it can cause side symptoms: headache and joint pain, nausea, vomiting, anaphylactic shock, hypotension. The main contraindication to taking the drug is individual intolerance to its components.

How to prevent infection of the body with cytomegalovirus

How to treat cytomegalovirus has been clarified. It is worth mentioning methods of prevention, because if you take all preventive measures, you can significantly reduce the risk of pathology. For this reason, it is recommended to follow the following recommendations:

1. Limiting contact with people suffering from cytomegalovirus infection.
2. Systematic ventilation of premises, including industrial and public areas, where there are large crowds of people.
3. Preventive examinations of women both during pregnancy and during the planning stage, even if there are no obvious symptoms.
4. Testing donor blood for the presence of cytomegalovirus infection.

And, of course, the most important rule for preventing the disease is timely visits to the doctor, at the first warning symptoms.

If you say the literal translation from Latin, it means a large cell.

Statistics show that about 70% of the entire female population are carriers of this pathogenic microorganism. The greatest danger is primary infection, since there is a high probability of negative effects on the health of the unborn baby.

1. Relatively low level of pathogenicity. After penetration into the human body, the disease may not develop for a long time. To provoke the development of cytomegaly, conditions are necessary under which the body’s protective functions are weakened (oncopathologies, difficult childbirth).
2. The reproductive capacity of the virus is low.
3. Cell destruction occurs due to the use of its protein fraction.
4. The reproduction of CMV stops after the body’s immune forces are restored, and a repeated inflammatory process may appear after another decrease in immune defense.
5. Under the influence of the environment, cytomegalovirus quickly dies. It is affected by both high and low temperatures, aseptic and disinfectants, and alcohol-containing solutions.
6. The risk of infection increases significantly when in contact with a patient or carrier of CMV.
7. Most often, infection occurs in childhood, when the clinical picture of the disease has severe symptoms. Infection in adults occurs asymptomatically, which significantly complicates the diagnosis.

The development of cytomegalovirus is facilitated by factors in which the body’s defenses malfunction. The following pathological conditions are included in their composition:

1. AIDS disease.
2. Systemic diseases of the circulatory system.
3. Malignant neoplasms.
4. Extensive wound surfaces, including after burns.
5. The use of long courses of treatment with drugs from the pharmaceutical group of glucocorticoids or cytostatics (they suppress the functioning of the immune system).

In some cases, the penetration of this virus is facilitated by:

• polluted environment;
• lack of sufficient vitamins, micro and macroelements;
• transferring the child to artificial feeding;
• violation of the daily routine, which is accompanied by a lack of walks in the fresh air.

Routes of transmission of the virus

This type of pathological process is anthroponotic. It can only occur in humans, and it can only occur in humans.

In this regard, the following routes of infection are identified:

1. Intrauterine. Infection of the baby occurs through the placenta.
2. During delivery. When the fetus passes through the mother's birth canal, the virus penetrates the mucous membranes.
3. In case of contact with the oral cavity infected saliva ().
4. If sexual intercourse occurs without the use of barrier contraception(do not use a condom).
5. With parenteral administration of donor blood or after an organ transplant operation.

Clinical picture of the virus in acute and chronic forms in women

If a woman has strong immunity, then the virus that has entered her body is in an inactive phase of its development, and therefore does not cause clinical manifestations. The impetus for the appearance of its symptoms is a weakening or malfunction of the immune system. This may occur as a result of:

• prolonged hypothermia;
• psycho-emotional breakdown after experiencing a stressful situation;
• excessive fatigue;
• long-term chronic diseases;
• pregnancy and childbirth.

After CMV enters the body, it begins to actively multiply, involving new cells in the process. However, throughout the entire period (up to 2 months), clinical symptoms may be absent.

The acute phase of the disease most often lasts about 6 weeks, it may be accompanied by symptoms reminiscent of a cold or mononucleosis.

Unfortunately, there are no characteristic signs indicating the presence of cytomegalovirus in the body. Therefore, most women at the onset of the disease do not pay due attention to the problem that has arisen.

Initially, a woman experiences the following symptoms:

1. There is a rise in body temperature, which is difficult to control.
2. Loss of strength, weakness, muscle pain, and aching joints appear.
3. There is a hacking cough and symptoms of rhinitis.
4. The salivary glands become enlarged and hypersalivation (increased salivation) is observed.
5. There is an increase in the size of the cervical, submandibular, and parotid lymph nodes, which are accompanied by pain in the throat.
6. Symptoms of anorexia appear.
7. A fear of bright, sunlight develops.

With timely treatment and the correct therapy, these symptoms may disappear in 2 or 4 weeks. Otherwise, the process becomes chronic. This threatens the appearance of the following pathological conditions:

• endometritis;
• vaginitis;
• erosive lesions of the cervix.

In addition, women experience nagging pain in the lower abdomen, which is accompanied by abnormally blue vaginal discharge.

Cytomegalovirus infection poses a particular threat during the period when a woman is pregnant. There is a risk of premature birth, spontaneous miscarriage or fetal death

If the disease occurs in the first trimester of pregnancy, the risk of physical and mental pathologies in the baby increases significantly, which can be expressed as follows:

1. The baby's skull may be small, which leads to disruption of the structure of the brain.
2. Abnormal development of the heart septa, leading to the development of heart defects.
3. Disorders in the development of the hearing system and visual organs.
4. Improper development of the lungs and kidneys.
5. In addition, such a child will have a physical developmental delay compared to his peers.

CMV disease in late pregnancy is not so dangerous for the unborn baby. But the risk of premature birth remains the same. A child may be born with signs of hypoxia, and will have low scores on the Apgar scale (which determines the degree of full-term birth of the child).

He may experience:

• poor weight gain due to a weak sucking reflex;
• yellowness of the skin (a sign of disruption of the biliary tract);
• hemorrhagic rashes on the skin;
• constant increase in body temperature;
• a malfunction of the digestive system, which is accompanied by vomiting (resembling coffee grounds).

This condition of the child is severe and often leads to death between the 14th and 20th day of life.

Course and complications of immunodeficiency conditions in women

The long-term chronic course of this pathology occurs against the background of immunodeficiency. In this case, the woman develops generalized damage to various organs and systems:

1. Gastrointestinal tract, affected by cytomegalovirus, leads to the development of colitis or enterocolitis, in severe cases to cirrhosis of the liver. The mucous membranes of the esophagus and intestines can ulcerate, and in this case there is a risk of a perforated ulcer. Penetration of stomach or intestinal contents into the abdominal space threatens the development of diffuse peritonitis. This is a dangerous, complicated condition that requires surgical intervention.
2. Genitourinary system may react with the appearance of inflammatory processes in the genital organs. Stones form in the kidneys in a relatively short period of time; this is a consequence of metabolic disorders in the body.
3. From the nervous system Encephalitis may develop, the psycho-emotional state may be disturbed, with the appearance of symptoms of apathy and dementia (dementia).
4. In the respiratory system, CMV can cause the development of pneumonia, which is characterized by an acute course and is difficult to respond to drug therapy.
5. In case of damage to the visual organs, Cytomegalovirus affects the retina of the eye and contributes to its rapid necrosis. This initially leads to impaired visual perception, and ultimately to complete loss of vision.

Methods used to diagnose the presence of a virus in the body

To establish an accurate diagnosis, examining the patient and listening to his complaints is not enough. In addition, this pathology must be differentiated (distinguished) from the disease mononucleosis. Its symptoms resemble the course of Cytomegaly, but unlike it, there are no diseases during the process, and the inflammatory process is not accompanied by enlargement of the lymph nodes, which are localized in the occipital region.

Therefore, the doctor prescribes additional research methods for which biological material is collected. It can be:

• and urine;
• salivary gland discharge;
• contents of bronchopulmonary secretion;
• breast milk;
• genital scrapings;
• tissue particles taken during a biopsy.

Currently, several methods are used, using which we can speak with a high degree of confidence about the presence of the virus in the body:

1. The most accessible and inexpensive method is using a microscope. A significant drawback is the low accuracy of this type of study (approximately 70%).
2. PCR. This technique is based on the detection of DNA particles of Cytomegalovirus, which makes it possible to determine its presence in the body. This is a fairly accurate analysis, but it has one drawback, which does not allow one to determine the duration of the inflammatory process. It can also be considered an expensive type of diagnostics.
3. (ELISA). This technique is based on identifying antibodies that develop in the body in relation to the pathogen. It is used to make a diagnosis at any stage of the disease and has high informative accuracy.
4. Cytological examination. To carry out this analysis, a small piece of tissue is taken and placed in a nutrient medium. The development of the virus is observed for 3 weeks. If large cells are detected that have internal inclusions, a positive result is given regarding the presence of cytomegalovirus in the body.

The use of specific and non-specific therapy methods in treatment

This type of disease has its own specifics and course characteristics. Therefore, proper effective therapy can be ensured by contacting a specialist at a medical facility.

When carrying out drug treatment (specific therapy), drugs are used that can eliminate the causes of the pathological process and restore the functioning of the immune system.

To suppress the multiplication of a viral infection, antiherpetic drugs are prescribed:

• Ganciclovir;
• Foxarnet;
• Zovirax;
• Acyclovir.

These dosage forms can only be prescribed by a doctor, due to the fact that they have a toxic effect on the body. Their incorrect use can lead to the development of side effects, which will take a long time to eliminate. B vitamins;

To stimulate the immune system, you can use traditional healing methods (non-specific therapy). The use of tinctures and decoctions gives positive results only if they are used not as a panacea, but as an additional therapy.

In this case, it is necessary to consult a doctor about choosing a particular herbal remedy.

For this purpose, they usually resort to prescribing the following infusions or decoctions:

• echinacea tincture; echinacea decoction;
• tincture of Schisandra chinensis;
• medicinal tea with thyme;
• complex decoction based on immortelle, St. John's wort and chamomile;
• tincture of birch buds.

Basic preventive measures to prevent the development of the virus

In medical practice, there is no specific prevention of this pathology, so you should adhere to the basic principles of hygiene that will help prevent the development of this disease:

1. First of all, it is necessary to exclude casual sexual contacts. Use a barrier method of contraception (condom).
2. In active disease, the infected person is the source of infection. Therefore, he should have separate personal care products and dishes.
3. Wash your hands frequently with soap and water.
4. When planning pregnancy, it is necessary to carry out laboratory tests for the presence of a viral infection.
5. The diet should include a high content of coarse fiber and. Food should be varied and contain a large number of micro and macroelements.
6. To create a good immune barrier, you need to exercise and strengthen your body.

These simple measures do not fully guarantee the development of cytomegaly. But in most cases, they prevent the development of this infection.

Cytomegalovirus poses a serious threat to the body of a girl and a pregnant woman. It can cause irreparable harm to the proper functioning of organs.

To prevent complications from occurring, you must consult a doctor who will prescribe the correct treatment.

Patients should remember that folk recipes cannot cure this disease, since in most cases they mask the clinical picture without eliminating the main cause of the pathological process.

Doctor   Dmitry Sedykh

Cytomegalovirus is quite common among the population and by the age of fifty every person acquires it. The virus is transmitted sexually, through biological fluids and may not appear in the body for some time. With strong immunity, the action of the pathogen is suppressed. Cytomegalovirus is especially dangerous in women when the body's defenses are reduced.

Cytomegalovirus infection in women is a dangerous type of herpes that can affect reproductive function. The pathogen contains its own DNA, and when it infects host cells, it causes their atypical growth and affects their ability to divide. In most patients it is in an incubation state and does not cause health problems. It is impossible to eliminate cytomegalovirus from the body.

The only condition for the virus to remain in a dormant form is that the woman does not have immunodeficiency syndrome and is not pregnant, when the virus poses a danger. When activated, cytomegalovirus predominantly occurs in the form of mononucleosis, and also contributes to the combined development of sialadenitis, rhinitis, nephritis, viral hepatitis and other diseases.

Cytomegalovirus in women

Cause of occurrence

Cytomegalovirus infection appears in the body of a healthy person only through direct contact with an infected person. Therefore, the cause and source of infection is a person who is a carrier of cytomegalovirus infection.

There are several routes of infection through which the pathogen enters the body of a healthy woman:

1. Unprotected sexual intercourse, as a result of which cytomegaly enters along with secretions from the partner’s genitals. Infection through oral sex is possible, but barrier contraception significantly increases the chances of protecting yourself from the disease.
2. Transplacental route of transmission– in this case, the pathogen enters the child’s body from a sick mother. Cytomegalovirus is detected in one percent of newborns who received the pathogen via the transplacental route. There is also a risk of getting cytomegalovirus when passing through the birth canal and during breastfeeding. When infected in utero, the child develops severe pathologies.
3. Household route - becomes relevant when the infection recurs, if a sick person releases cytomegalovirus into the environment. It is possible to become infected through airborne droplets, by sharing common objects, or by kissing. The virus is found in almost all people who frequently come into contact with an infected person or live in the same area with him.
4. Blood transfusion route– the virus appears in the body of a healthy person after a blood transfusion or injection. Happens after organ transplantation, blood transfusion, among antisocial elements who use injecting drugs. Cytomegalovirus threatens medical personnel who often have contact with syringes and needles and who work in operating rooms.

Cytomegalovirus penetrates all tissues and organs, and many people do not even suspect that they live with a person who is a carrier of such an infection. The risk group includes drug addicts, people who do not adhere to sexual morality, and people with exacerbations of CMV infection.

Cytomegalovirus: pathogen, transmission routes, carriage, re-infection

How does cytomegalovirus manifest itself?

The peculiarity of cytomegalovirus infection is that it does not differ in its own specific symptoms, but CMV in women is disguised as various diseases that it causes. Cytomegalovirus infection can occur in acute and generalized forms, with damage to internal organs.

Acute symptoms

Depending on the form of the disease in women, cytomegalovirus produces different symptoms. The latent course of the disease will not reveal itself with any manifestations until the influence of the provoking factor occurs. In this case, cytomegalovirus manifests itself acutely.

Externally, the first signs of the disease are more similar to infectious mononucleosis. Symptoms of cytomegalovirus in a woman appear suddenly - fever, weakness, headache, chills. Temperature rises to high levels. A typical sign of mononucleosis is damage to the lymph nodes. Women complain of noticeably enlarged lymph nodes that hurt when touched, they are soft and mobile to the touch.

At the initial stage of development of the disease, only the cervical lymph nodes are affected, but already some time after infection, symptoms are felt in the axillary, inguinal and submandibular zone. Lymphadenopathy is the first sign of the acute form and is the last symptom to disappear. Also, women with cytomegalovirus complain of discomfort in the right hypochondrium with an enlarged liver and spleen, inflammation of the joints, and in a blood test doctors find atypical mononuclear cells confirming the diagnosis. In the absence of effective treatment, chronic cytomegalovirus infection appears.

Symptoms of cytomegalovirus: pain, sore throat, rashes, discharge, hair loss

Symptoms of the generalized form

Signs of a generalized form appear when internal organs are affected. In this case, the signs of cytomegalovirus in women are disguised as symptoms of other diseases, so careful diagnosis is required. Transition to a generalized form is possible if a woman has an immunodeficiency or has recently undergone radiotherapy or chemotherapy, which significantly reduces immunity. The generalized form occurs together with other diseases.

Cytomegalovirus in women can cause pneumonia and hepatitis, involving the cells and blood vessels of these organs in the pathological process. Typical inflammation, infiltration and tissue necrosis occurs. When liver cells die, they slough off and enter the bile duct, causing obstruction of the passage and stagnation of bile. A typical consequence of this process is jaundice; women are bothered by vomiting and nausea.

When entering the lungs, cytomegalovirus affects the walls of the alveoli and capillaries, the tissues located around the vessels. It is difficult to cure such pneumonia, so its symptoms in women are observed for quite a long time. When a bacterial infection occurs, the patient's health condition worsens - body temperature rises, respiratory failure, shortness of breath, and cough with copious discharge occur.

When the fiber of the visual organs is damaged, cytomegalovirus attacks both eyes. Retinitis in women has a typical course - photophobia, goose bumps before the eyes, blurred vision appear.

If the virus infects the salivary glands, the parotid glands are predominantly affected. The inflammatory process provokes an increase in body temperature, pain is felt behind the ear in the form of sharp shootings, due to a decrease in saliva secretion, constant dry mouth and discomfort when chewing food.

The genitourinary system in women also becomes a target for cytomegalovirus. The pathogen affects the glomeruli, capsule and tubules, which provokes renal failure. In the urine you can see sediment from dead epithelium and cytomegalovirus cells.

As for the genital organs, gynecology also suffers. The pathogen causes the development of salpingitis, cervicitis, and endometritis. A nagging or aching pain may persist in the lower abdomen for a long time, intensifying in women during sexual intercourse or urination.

Cytomegalovirus detected - what to do?

Diagnostics

To diagnose cytomegalovirus in women, clinical signs of the development of the disease are not enough, since quite often doctors make mistakes in the diagnosis. Therefore, laboratory tests of blood and urine are mandatory to make a diagnosis. Diagnosis of women and newborns is extremely important.

The search for viral markers is justified in the presence of clinical signs indicating possible activation of cytomegalovirus. For example, tests are done on all children who were born prematurely with jaundice and have central nervous system damage. In women carrying a baby, examination for cytomegalovirus is carried out during complicated pregnancies, which can be confirmed by ultrasound screening.

The most effective are virological methods for determining cytomegalovirus, in which either the cytomegalovirus itself can be isolated, as well as the appearance of specific antibodies in the blood can be diagnosed. The subject of the study is a biological fluid, most often blood, and in pregnant women and women in labor they can additionally collect urine and milk. Using the immunoperoxidase method and immunofluorescence, it is possible to isolate the pathogen within the first or second day after donation of the biomaterial.

Polymerase chain reaction is used to determine the genome of the virus. This diagnostic method allows you to sense not only the genetic material of active pathogens, but also those that are in a latent form. If the result is positive, this means the presence of a latent form of carriage and the presence of antibodies to the virus.

Despite the fact that the method is quite modern and highly sensitive, errors are possible when obtaining PCR results. In order not to make an erroneous diagnosis based on a false-positive result, tests are carried out in parallel, several types of diagnostics are used, for example, using an enzyme-linked immunosorbent assay.

Diagnosis of cytomegalovirus: research methods, differential diagnosis

Cytomegalovirus is an infection that is ubiquitous among all categories of the population and is characterized by a variety of symptoms. The disease can be asymptomatic or with severe complications. Usually, when entering the human body for the first time, the infection does not make itself felt and is activated only when the immune system malfunctions.

According to statistics, every fifth baby under one year of age is a carrier of cytomegalovirus. The most dangerous route of infection is intrauterine. 5-7% of all children are infected in this way.

About 30% of cases of infection occur during breastfeeding, when the baby picks up the virus through breast milk. The probability of transmission of a pathogenic microorganism from a pregnant woman to a child is 30-50%.

An infected baby may be born with a number of serious problems:

• neurosensory disorders;
• mental defects;
• partial or complete hearing loss.

The remaining children are infected by airborne droplets in organized groups. In adolescence, 15% of people are carriers of the infection, in adults – 40%, and in old age (over 50) – 99%.

Causes

Cytomegalovirus infection develops due to the penetration of a herpes microorganism into the human body. The pathogen cell contains DNA molecules whose size does not exceed 180 nm. As the virus develops, the cells gradually increase in size, transforming into cytomegalic cells.

The cell of the pathogen has the following properties:

• keeps for a long time at room temperature;
• killed by freezing and boiling;
• breaks down in an acidic environment.

The virus can penetrate any organ and tissue of the human body. The severity of the clinical picture depends on the form of the pathogen and the immune system of the infected person.

The virus actively spreads through biological fluids. There is a high risk of infection if:

• kisses;
• use of general hygiene products;
• unprotected sexual relations:
• blood transfusion;
• the passage of a child through the birth canal of an infected mother;
• ingestion of amniotic fluid by the baby during surgical delivery.

It is very easy to catch an infection, so in most cases, infection occurs in childhood. An infected adult rarely shows symptoms of the disease. The introduction of cytomegalovirus into the body is often due to a decrease in the body’s defenses, which occurs due to:

The functioning of the immune system is indirectly affected by environmental factors, lack of vitamins and microelements in the body, and insufficient nutrition. With artificial feeding and insufficient exposure to fresh air, the baby’s body becomes more susceptible to the introduction of bacteria and viruses. An infected child, as a rule, remains a carrier of this type of infection forever.

Symptoms

Signs of pathology manifest themselves differently, depending on the age and gender of the patient. Therefore, the clinical picture of the disease in men, women and children should be separately considered.

Signs of cytomegalovirus in men

Most often, the disease in representatives of the stronger sex manifests itself in an inactive form. The main causes of infection in men are weakened immunity, constant stressful situations, and colds.

Among the main symptoms of pathology in men are:

• slight rise in temperature;
• swelling of the mucous membranes of the nose and throat;
• brittleness in joints and bones;
• inflammation of the lymph nodes;
• damage to the genitourinary system.

These symptoms appear only a few months after infection. The main difference between this disease and ARVI is its duration. The clinical picture of CMV can last 4-6 weeks, while colds in the acute stage last no more than 2 weeks.

From the moment the microbe is introduced into the body, a person becomes its active carrier. The patient has been a threat to others for 3 years.

Serious problems in the immune system lead to a more acute manifestation of a viral infection:

• liver and kidney damage;
• central nervous system disorders;
• heart attack;
• pneumonia;
• encephalitis.

The disease causes paralysis and death. The susceptibility of the stronger sex to this type of pathology is very high, but with normal immune function, infection rarely develops.

Signs in women

As in men, the symptoms of cytomegalovirus in the fair sex are similar to respiratory diseases. A woman may not be aware of the pathology, attributing the malaise to a common cold. In 2-4 weeks, the body produces a sufficient level of antibodies to the pathogen and independently recovers from the disease. But sometimes, when the immune system is unable to eliminate the pathogenic organism, the disease becomes chronic.

As a result, the following pathological processes may occur:

• endometritis;
• vaginitis;
• oophoritis;
• cervical erosion.

In its acute form, cytomegalovirus infection is similar in symptoms to bacterial mononucleosis. It begins with a sharp rise in body temperature and chills. The main symptom of this period is a significant increase in lymph nodes from 0.5-3 cm. Initially, the pathological process spreads to the cervical nodes, and then spreads to the submandibular, axillary and inguinal nodes. Lymphadenopathy, as a sign of cytomegalovirus infection, appears first and disappears last.

In the acute stage of the disease, other signs may appear:

• general weakness;
• enlargement of internal organs;
• increase in leukocytes in the CBC.

The disease differs from infectious mononucleosis in the absence of signs of tonsillitis. Also, with cytomegalovirus pathology, inflammation of the occipital lymph nodes is rarely observed.

Pregnant women are most vulnerable to the disease. If patients already have an infection, the risk of its recurrence increases. When cytomegalovirus relapses, pregnant women often notice discomfort in the lower abdomen and bluish vaginal discharge. In this case, CMV can manifest itself in a number of complications:

• early placental abruption;
• polyhydramnios;
• large loss of blood during childbirth;
• incorrect location of the placenta;
• miscarriage.

Signs in children

For a child, intrauterine infection poses the greatest threat. In this case, he is born with many physical abnormalities:

• delayed development and growth;
• several types of vasculitis;
• skin rashes;
• sensory organ disturbances;
• enlarged internal organs.

The skin rash covers almost the entire body of the baby. Cytomegalovirus is often accompanied by hemorrhage under the mucous membranes or skin, accompanied by bloody discharge from the umbilical wound and anus.

Damage to the baby’s central nervous system leads to trembling of the limbs and increased fatigue. Sometimes the symptoms of cytomegalovirus infection in a newborn are not accompanied by characteristic signs.

Given this fact, a pregnant woman who has not had antibodies to this disease should be more attentive to her health and avoid crowded places.

Diagnostics

How the disease is detected depends on the type of infection and how it manifests. For example, in the case of a congenital form of the disease, it makes no sense to isolate the pathogen in cell culture. For a chronic type of problem, a serological test is prescribed, which detects the level of antibodies in the body.

To obtain reliable results, several laboratory tests are carried out at once. To do this, analyze:

• saliva;
• blood;
• genital discharge
• urine;
• bronchopulmonary secretion;
• breast milk;
• tissue obtained by biopsy.

The most accessible diagnostic method is blood smear microscopy. The accuracy of this technique is low - up to 70%.

Among the main methods for diagnosing the disease, the following should be noted:

To diagnose pathology, several blood samples are taken from newborns over a period of 30 days and the IgG titer is assessed. A deviation of this indicator from the norm by more than 4 times indicates that the child is infected.

Treatment

Completely getting rid of the causative agent of the disease is impossible, as is independent choice of drugs to combat the problem. The disease progresses individually in each patient, so a set of medications should be selected by a specialist, taking into account the test results.

When treating pathology, the patient’s health condition is taken into account:

• therapy is not prescribed to persons who do not have chronic diseases or other problems;
• people with weakened immune systems require urgent treatment.

Complex therapy for infection combines several areas - destroying the cause of the disease and maintaining the body's defenses. The following drugs are used to fight the virus:

1. Ganciclovir.
2. Foxarnet.
3. Valganciclovir.

All of these drugs are toxic and have a wide range of side effects. An incorrectly selected dose of the drug or its inappropriate use can lead to an even greater weakening of the patient’s immunity.

In some cases, a specialist prescribes therapy with immunoglobulin, a medicine prepared from human blood and containing the required amount of antibodies to the infection. This drug is administered intravenously according to a strictly prescribed schedule. In practice, the use of immunoglobulin has proven its effectiveness, but its effectiveness has not been scientifically proven.

Treatment with immunoglobulin has a number of contraindications:

• simultaneous administration of vaccines containing other strains of the virus;
• chronic pathologies;
• a person’s tendency to allergic reactions;
• kidney diseases;
• period of pregnancy and breastfeeding.

If during therapy changes in the body are observed - shortness of breath, problematic urination, the appearance of signs of cold pathologies, then the treatment is adjusted. To get rid of the disease, patients are often recommended to combine Ganciclovir or Foscarnet with interferons - Viferon or Reaferon.

Often, against the background of a viral disease, a person develops a secondary bacterial infection, the treatment of which requires the use of antibiotics.

For additional therapy, the patient is prescribed:

Before starting therapy, it is important to identify the cause of the immune system disorder. According to experts, Anaferon, Amiksin or Cycloferon are most suitable for restoring the body’s defenses.

Prevention

Cytomegalovirus poses the greatest danger to pregnant women and the fetus.

It is also important to prevent the patient from coming into contact with HIV-infected people, infants and people with chronic diseases.

1. Conducting regular screening tests in pregnant women.
2. Immunization with live attenuated vaccine or immunoglobulin. In the first case, active immunity is developed, in the second - passive immunity.
3. Limiting breastfeeding. In such a situation, it is recommended to use artificial nutrition to feed the baby.