Cytomegalovirus infection pathophysiology: Difference between revisions

Jump to navigation Jump to search
No edit summary
Line 16: Line 16:
*In majority of [[immunocompetent]] people, primary [[Cytomegalovirus infection|CMV infection]] is sub clinical and asymptomatic.
*In majority of [[immunocompetent]] people, primary [[Cytomegalovirus infection|CMV infection]] is sub clinical and asymptomatic.
*Following primary infection the [[virus]] persists in a latent form in the host tissues invading the [[immune system]].
*Following primary infection the [[virus]] persists in a latent form in the host tissues invading the [[immune system]].
*Reactivation can occur in response to [[inflammatory]] stimuli, physiologic stress and immunosuppression releasing new virions that can infect new cells causing cmv end organ infection.
*Reactivation can occur in response to [[inflammatory]] stimuli, physiologic [[stress]] and [[immunosuppression]] releasing new [[virions]] that can infect new cells causing cmv end organ infection.
*T-cells play a role in controlling the replication of the virus.
*[[T-cells]] play a role in controlling the [[replication]] of the [[virus]].
*In patients with T-cell deficiency the viral replication is uncontrolled and results in excessive shedding of the virus.
*In patients with [[T cell|T-cell]] deficiency the viral [[replication]] is uncontrolled and results in excessive shedding of the [[virus]].
*Reactivation of the virus results in the release of cytokines such as  TNF-α and IFN-γ resulting in inflammation.
*Reactivation of the [[virus]] results in the release of [[cytokines]] such as  [[TNF-α]] and [[Interferon gamma|IFN-γ]] resulting in [[inflammation]].


===Genetics===
===Genetics===
*Patients with polymorphisms in the genes coding for mannose binding lectin and ficolin-2 are at a higher risk of developing CMV infection.<ref name="pmid27108521">{{cite journal| author=Klenerman P, Oxenius A| title=T cell responses to cytomegalovirus. | journal=Nat Rev Immunol | year= 2016 | volume= 16 | issue= 6 | pages= 367-77 | pmid=27108521 | doi=10.1038/nri.2016.38 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27108521  }} </ref>
*Patients with [[polymorphisms]] in the [[genes]] coding for mannose binding [[lectin]] and ficolin-2 are at a higher risk of developing [[CMV infection]].<ref name="pmid27108521">{{cite journal| author=Klenerman P, Oxenius A| title=T cell responses to cytomegalovirus. | journal=Nat Rev Immunol | year= 2016 | volume= 16 | issue= 6 | pages= 367-77 | pmid=27108521 | doi=10.1038/nri.2016.38 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27108521  }} </ref>


===Associated Conditions===
===Associated Conditions===
*Symptomatic cytomegalovirus is associated with HIV infection in majority of patients.<ref name="pmid27714898">{{cite journal| author=Grønborg HL, Jespersen S, Hønge BL, Jensen-Fangel S, Wejse C| title=Review of cytomegalovirus coinfection in HIV-infected individuals in Africa. | journal=Rev Med Virol | year= 2017 | volume= 27 | issue= 1 | pages=  | pmid=27714898 | doi=10.1002/rmv.1907 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27714898  }} </ref><ref name="pmid27625433">{{cite journal| author=Gianella S, Letendre S| title=Cytomegalovirus and HIV: A Dangerous Pas de Deux. | journal=J Infect Dis | year= 2016 | volume= 214 Suppl 2 | issue=  | pages= S67-74 | pmid=27625433 | doi=10.1093/infdis/jiw217 | pmc=5021239 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27625433  }} </ref>
*Symptomatic [[cytomegalovirus]] is associated with [[HIV AIDS|HIV infection]] in majority of patients.<ref name="pmid27714898">{{cite journal| author=Grønborg HL, Jespersen S, Hønge BL, Jensen-Fangel S, Wejse C| title=Review of cytomegalovirus coinfection in HIV-infected individuals in Africa. | journal=Rev Med Virol | year= 2017 | volume= 27 | issue= 1 | pages=  | pmid=27714898 | doi=10.1002/rmv.1907 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27714898  }} </ref><ref name="pmid27625433">{{cite journal| author=Gianella S, Letendre S| title=Cytomegalovirus and HIV: A Dangerous Pas de Deux. | journal=J Infect Dis | year= 2016 | volume= 214 Suppl 2 | issue=  | pages= S67-74 | pmid=27625433 | doi=10.1093/infdis/jiw217 | pmc=5021239 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27625433  }} </ref>


===Microscopic Pathology===
===Microscopic Pathology===
*Microscopically, CMV infection can be demonstrated by the presence of [[intranuclear]] [[inclusion]] bodies. These inclusion bodies stain dark pink on an [[H&E stain]], and are also called "Owl's Eye" inclusion bodies.
*[[CMV infection]] demonstrates the presence of [[intranuclear]] [[inclusion]] bodies. These [[inclusion bodies]] stain dark pink on an [[H&E stain]], and are also called "Owl's Eye" [[inclusion bodies]].


==References==
==References==

Revision as of 17:30, 30 May 2017

Cytomegalovirus infection Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Cytomegalovirus infection from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

Chest X Ray

CT

MRI

Echocardiography or Ultrasound

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Cytomegalovirus infection pathophysiology On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Cytomegalovirus infection pathophysiology

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Cytomegalovirus infection pathophysiology

CDC on Cytomegalovirus infection pathophysiology

Cytomegalovirus infection pathophysiology in the news

Blogs on Cytomegalovirus infection pathophysiology

Directions to Hospitals Treating Cytomegalovirus infection

Risk calculators and risk factors for Cytomegalovirus infection pathophysiology

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Qasim Salau, M.B.B.S., FMCPaed [2]

Overview

Transmission of CMV occurs from person to person and primary CMV infection causes activation of the immune system and resulting in a mononucleosis like presentation with hepatitis in immunocompromised individuals and few immunocompetent individuals. Reactivation can occur in response to inflammatory stimuli, physiologic stress and immunosuppression releasing new virions that can infect new cells causing CMV end organ infection.

Pathophysiology

Transmission

Pathogenesis

Genetics

Associated Conditions

Microscopic Pathology

References

  1. Ryan KJ, Ray CG (editors) (2004). Sherris Medical Microbiology (4th ed. ed.). McGraw Hill. pp. pp. 556, 566–9. ISBN 0838585299.
  2. Staras SAS, Dollard SC, Radford KW; et al. (2006). "Seroprevalence of cytomegalovirus infection in the United States, 1988–1994". Clin Infect Dis. 43: 1143&ndash, 51. PMID 17029132.
  3. Goodman AL, Murray CD, Watkins J, Griffiths PD, Webster DP (2015). "CMV in the gut: a critical review of CMV detection in the immunocompetent host with colitis". Eur J Clin Microbiol Infect Dis. 34 (1): 13–8. doi:10.1007/s10096-014-2212-x. PMC 4281362. PMID 25097085.
  4. Rafailidis PI, Mourtzoukou EG, Varbobitis IC, Falagas ME (2008). "Severe cytomegalovirus infection in apparently immunocompetent patients: a systematic review". Virol J. 5: 47. doi:10.1186/1743-422X-5-47. PMC 2289809. PMID 18371229.
  5. Khan TV, Toms C (2016). "Cytomegalovirus Colitis and Subsequent New Diagnosis of Inflammatory Bowel Disease in an Immunocompetent Host: A Case Study and Literature Review". Am J Case Rep. 17: 538–43. PMC 4968430. PMID 27460032.
  6. Einbinder Y, Wolf DG, Pappo O, Migdal A, Tsvang E, Ackerman Z (2008). "The clinical spectrum of cytomegalovirus colitis in adults". Aliment Pharmacol Ther. 27 (7): 578–87. doi:10.1111/j.1365-2036.2008.03595.x. PMID 18194509.
  7. Klenerman P, Oxenius A (2016). "T cell responses to cytomegalovirus". Nat Rev Immunol. 16 (6): 367–77. doi:10.1038/nri.2016.38. PMID 27108521.
  8. Grønborg HL, Jespersen S, Hønge BL, Jensen-Fangel S, Wejse C (2017). "Review of cytomegalovirus coinfection in HIV-infected individuals in Africa". Rev Med Virol. 27 (1). doi:10.1002/rmv.1907. PMID 27714898.
  9. Gianella S, Letendre S (2016). "Cytomegalovirus and HIV: A Dangerous Pas de Deux". J Infect Dis. 214 Suppl 2: S67–74. doi:10.1093/infdis/jiw217. PMC 5021239. PMID 27625433.

Template:WH Template:WS