Cytomegalovirus (CMV) Infection – Diagnosis and Treatment

Overview

Infection in Pregnant People and Newborns

Cytomegalovirus (CMV) can pass from a pregnant person to their unborn baby. This is called congenital CMV infection. Babies with congenital CMV are at risk for hearing loss, vision problems, low birth weight, and other long-term health concerns.

Sometimes, newborns show symptoms like jaundice, small head size (microcephaly), or even signs of neurological issues at birth. Doctors often check for congenital CMV with blood tests, urine tests, or saliva samples from newborns.

Early detection is important because some infants may benefit from treatment with antiviral agents. These medicines can lower the risk of hearing loss and other disabilities. Still, they may not be used in all cases due to potential side effects.

CMV in People with Weakened Immune Systems

People with weakened immune systems—such as those with HIV/AIDS, organ transplant recipients, or individuals undergoing bone marrow transplants—are at higher risk of severe CMV infections.

CMV can reactivate in these persons, leading to serious complications like retinitis (an eye infection that can cause vision loss), pneumonia, colitis, or encephalitis. Diagnosis usually involves a combination of blood tests, cultures, or sometimes tissue biopsies. Doctors watch for symptoms like fever, fatigue, or organ-specific complaints.

In these patients, antiviral medicines are often necessary to control the infection. These drugs help reduce viral replication but may cause side effects, including nephrotoxicity and low white blood cell counts. Common issues in people with weakened immunity:

Complication	Description
CMV Retinitis	Eye infection, risk of blindness
CMV Pneumonia	Serious lung infection
CMV Colitis	Inflammation of the colon
Encephalitis	Brain inflammation
Organ Rejection	CMV may trigger organ rejection

Close monitoring and frequent blood tests are often needed during and after treatment. Hand washing and careful screening of blood transfusions or organ donors also help reduce spread among high-risk groups.

Diagnosing Cytomegalovirus Infection

Reviewing Patient History and Conducting a Physical Exam

Healthcare providers begin by asking about symptoms and risk factors. This includes recent illnesses, possible exposures to infected individuals, and any immune system problems. A physical exam may be done to check for signs such as fever, swollen lymph nodes, or a rash.

Laboratory Testing

Laboratory tests play a key role in finding CMV infection. Blood samples are tested to look for CMV DNA, antibodies, or proteins related to the virus. Polymerase chain reaction (PCR) is commonly used to find viral genetic material. Sometimes, saliva or urine samples are tested for CMV as well.

Test Type	Sample Used	Purpose
PCR	Blood/Saliva	Detects CMV DNA in the body
Antibody Testing	Blood	Checks for immune response to CMV
Antigen Testing	Blood/Urine	Finds viral proteins in the system

Imaging Studies and Further Assessments

In some cases, doctors may order imaging tests, such as ultrasounds or CT scans, especially if the CMV infection has affected organs. These studies help check for complications like liver or brain involvement. Sometimes, tissue samples may also be taken for more testing if CMV disease is suspected in specific organs.

Testing and Diagnosis Before Birth

For pregnant women at risk, certain tests can help find CMV infection in the unborn baby. Tests may involve examining the mother’s blood or using ultrasound to look for signs in the baby. In some cases, amniotic fluid may be collected to directly look for the virus in the fetus.

Treatment

Management in Individuals with Healthy Immune Systems

Most people with healthy immune systems do not need medication for cytomegalovirus (CMV) infection. The body’s natural defenses often control the virus on their own. Symptoms, if present, are usually mild and may be managed at home with rest, fluids, and over-the-counter pain relievers like acetaminophen.

Use of Antiviral Drugs

For those who require treatment, especially people with more serious symptoms, doctors may prescribe antiviral medicines. These drugs work by slowing down the virus’s ability to multiply in the body. Treatment plans depend on the patient’s health and how severe the infection is.

Care for Newborns with Congenital CMV

Newborns diagnosed with congenital CMV may require antiviral therapy if the infection leads to symptoms such as hearing loss, developmental delays, or growth issues. Treatment usually continues for several weeks to several months, depending on the severity of the condition and the infant’s response to therapy.

Unique Needs of People with Weakened Immune Systems

Patients with weakened immune systems, such as those with HIV, recent organ transplants, or cancer treatment, face more serious risks from CMV. For these individuals, doctors may recommend:

• Starting antiviral medication quickly when the infection is detected.
• Continuing the medicine for a longer period to prevent the virus from coming back.
• Regular monitoring of the virus through blood tests.

Doctors may adjust the type or dose of medicine based on how well the patient tolerates treatment and how well the virus is controlled.

Home Care and Symptom Management

Relieving Discomfort and Symptoms at Home

People with cytomegalovirus (CMV) infection can often manage mild symptoms at home. Using over-the-counter pain medicine like acetaminophen or ibuprofen can help lower fever and reduce body aches.

Rest is important, as it helps the body fight the virus. Staying hydrated is also important. Drinking enough water can prevent dehydration, especially if there is fever. Using a cool compress may ease headaches or muscle pain.

Simple Tips for Comfort

• Take naps or rest whenever feeling tired.
• Use a clean humidifier for a sore throat or dry cough.
• Wash hands often to avoid spreading the virus.

Diet and Everyday Habits

Healthy eating can support recovery from a CMV infection. Eating a balanced diet with fruits, vegetables, whole grains, and lean protein helps keep the immune system strong. Other lifestyle habits that help:

Habit	Benefit
Drink water often.	Prevents dehydration.
Avoid alcohol.	Reduces stress on the liver.
Limit junk food.	Prevents feeling sluggish.
Rest enough.	Helps the body recover faster.

Tip: Do not share drinks, food, or utensils if you have CMV, to lower the risk of passing it to others.

Sticking to healthy routines and practicing good hygiene, like frequent handwashing, is important for recovery and to stop the virus from spreading to others.

Getting Ready for Your Doctor Appointment

It helps to be prepared before seeing a doctor about cytomegalovirus (CMV) infection. Bringing important information can make the visit more helpful. Make a list of symptoms, even if they seem minor.

Write down when they started and if they have changed. Bring a list of all medicines, vitamins, or supplements being taken. This includes over-the-counter drugs.

Write down any recent illnesses, travel, or contact with sick people. If there is a history of problems with the immune system, mention it. Prepare questions ahead of time. For example:

• What tests will be needed?
• What are the treatment options?
• How can CMV infection affect daily life?
• Are there steps to avoid spreading it to others?

Having support can help. Consider asking a family member or friend to come along and take notes.

Item to Bring	Why It’s Needed
List of symptoms	Helps explain your situation.
Medication and supplement list	Avoids drug interactions.
Medical history	Gives a clearer health picture.
Questions for the doctor	Ensures important topics are covered.

Being organized and prepared can lead to a more productive discussion and help the doctor choose the right tests or treatments.