Cytomegalovirus: Symptoms, Types, Treatment, Prevention, Causes, Diagnosis and Complications

It is a common herpes virus. Many people do not know they have it because they may not have symptoms.

But the virus, which remains inactive in the body, can cause complications during pregnancy and for people with a weakened immune system.

The virus is transmitted through body fluids and can pass from a pregnant mother to her unborn baby.

Cytomegalovirus (CMV) is a member of the Herpesviridae family and usually causes an asymptomatic infection. It remains latent in patients, mainly in cells derived from bone marrow.

Primary CMV infection in immunocompetent individuals may also manifest as a type of mononucleosis syndrome, similar to the primary infection of Epstein-Barr virus, with fever, malaise, and lymphadenopathy.

CMV is a significant cause of morbidity and mortality among recipients of bone marrow or solid organ transplants, individuals with AIDS, and other immunosuppressed patients due to reactivation of the virus or a recently acquired infection.

Infection in these patient populations can affect almost any organ and lead to the failure of multiple organs.


Cytomegalovirus is also responsible for congenital diseases among newborns and is one of the infections by TORCH (toxoplasmosis, other infections such as syphilis, rubella, CMV, and herpes simplex virus).

The seroprevalence of Cytomegalovirus increases with age.

Symptoms of Cytomegalovirus

The symptoms will depend on the type of CMV Virus.

Most people with acquired Cytomegalovirus have no noticeable symptoms, but if symptoms do occur, they may include:

  • Fever.
  • Night sweats.
  • Tiredness and restlessness.
  • Sore throat.
  • Swollen glands
  • Pain in the joints and muscles.
  • Little appetite and weight loss
  • The symptoms will usually disappear after two weeks.


There are three main types of Cytomegalovirus infections: Acquired, Recurrent or Congenital.

  1. Acquired or primary CMV is a new infection.
  2. Recurrent Cytomegalovirus is when the patient is already infected. The virus is inactive and then becomes active due to a weak immune system.
  3. Congenital Cytomegalovirus is when the infection occurs during pregnancy and affects the fetus.

Cytomegalovirus is usually not a problem, except when it affects an unborn baby or a person with a weak immune system, such as a recent transplant recipient or a person with Human Immunodeficiency Virus (HIV).

In people with HIV, CMV infection can cause organ failure, eye damage, and blindness. The improvement in antiviral medication has reduced the risk in recent years.

The recipients of organ transplants and bone marrow must take immunosuppressants to reduce their immune systems so that their bodies do not reject the new organs.

Inactive CMV can be activated in these patients and cause organ damage. Transplant recipients can receive antiviral medications as a precautionary measure against CMV.

During pregnancy, cytomegalovirus infection can pass from the mother to the fetus. This is known as congenital CMV.

Most of these babies will not have signs or symptoms, but about 20 percent will have symptoms or long-term health complications, including learning difficulties.

Symptoms can be severe and include loss of vision and hearing, loss of vision, small head size, weakness and difficulty using muscles, coordination problems, and seizures.

Recurrent Cytomegalovirus

The symptoms of recurrent Cytomegalovirus vary, depending on which organs are affected. The areas that may be affected are the eyes, the lungs, or the digestive system.

Symptoms may include:

  • Fever.
  • Diarrhea, gastrointestinal ulcerations, and gastrointestinal bleeding.
  • Difficulty breathing.
  • Pneumonia with hypoxemia or a low level of oxygen in the blood.
  • Canker sores can be significant.
  • Problems with vision include floaters, blind spots, and blurred vision.
  • Hepatitis or inflamed liver with prolonged fever.
  • Encephalitis or inflammation of the brain causes changes in behavior, seizures, and even coma.

A person with a weakened immune system who experiences these symptoms should seek medical attention.

Congenital Cytomegalovirus

About 90 percent of babies born with CMV have no symptoms, but 10 to 15 percent will develop hearing loss, usually during the first six months of life.

The severity varies from mild to total deafness.

Only one ear will be affected in half of these children, but the rest will have hearing loss in both ears.

Hearing loss in both ears can lead to an increased risk of speech and communication problems later.

If there are symptoms of congenital CMV at birth, they may include:

  • Jaundice.
  • Pneumonia.
  • Red spots under the skin.
  • Purple skin spots, rash, or both.
  • Liver enlarged.
  • Enlarged spleen
  • Low birth weight
  • Convulsions

Some of these symptoms are treatable.

In about 75 percent of babies born with congenital Cytomegalovirus, the brain will have an impact. This can lead to challenges later in life.

The conditions they may face include:

  • Autism.
  • Loss of central vision, scarring of the retina and uveitis, or eye swelling and irritation.
  • Cognitive and learning difficulties.
  • Deafness or partial loss of hearing.
  • Epilepsy.
  • Vision problems.
  • Problems with physical coordination.
  • Convulsions
  • Small head.


Scientists have been looking for a vaccine against the CMV virus, but there is still no cure.

People with acquired CMV, who are infected for the first time, can use over-the-counter pain relievers such as Tylenol (Acetaminophen), Ibuprofen, or Aspirin to relieve symptoms and drink plenty of fluids.

Patients with congenital or recurrent CMV can use antiviral drugs such as ganciclovir to decrease the spread of the virus.

These medications can have adverse effects. If there is extensive damage to an organ, hospitalization may be necessary.

Newborns may need to stay in the hospital until the functions of their organs return to normal.


The following precautions can help reduce the risk of getting Cytomegalovirus:

  • Wash your hands regularly with soap and water.
  • Avoid kissing a small child, including contact between tears and saliva.
  • Avoid sharing glasses and kitchen utensils, for example, when passing a glass.
  • Dispose of diapers, tissues, and similar items carefully.
  • Use a condom to prevent the spread of Cytomegalovirus through vaginal fluids and semen.


Acquired Cytomegalovirus can spread to people through body fluids, such as saliva, semen, blood, urine, vaginal fluids, and breast milk.

The infection can also occur when you touch an infected surface with saliva or urine and then touch the inside of your nose or mouth.

Most humans become infected during childhood, in kindergarten centers, nurseries, and places where children directly contact each other.

However, the child’s immune system can usually treat infection at this age.

Recurrent CMV can occur in patients with a weakened immune system due to HIV, organ transplantation, chemotherapy, or oral steroids for more than three months.

Typically, congenital CMV occurs when a woman is infected with Cytomegalovirus for the first time, either during pregnancy or shortly before conception.

A latent CMV infection may reappear during pregnancy, especially if the mother has a weakened immune system.


A blood test can detect the antibodies created when the immune system responds to the presence of CMV.

A pregnant woman has a minimal risk of reactivation by infecting her developing baby.

If the infection is suspected, you can consider amniocentesis, which involves removing a sample of amniotic fluid to determine if the virus is present. If congenital Cytomegalovirus is suspected, the baby should be tested within the first three weeks of life.

Tests will not be conclusive for congenital CMV after three weeks since the infection could have occurred after birth.

Any patient with a weakened immune system should be tested, even if there is no active CMV infection.

Regular monitoring of cytomegalovirus complications will include testing for vision and hearing problems.


Healthy people very rarely get significantly sick from CMV infection.

However, people with a weakened immune system may develop mononucleosis due to CMV, a condition in which there are too many white blood cells. With a single core.

Symptoms include sore throat, swollen glands, swollen tonsils, tiredness, and nausea.

It can cause inflammation of the liver or hepatitis and enlarge the spleen. CMV mononucleosis is similar to classical mononucleosis caused by the Epstein-Barr virus.

Mononucleosis due to EBV is also known as glandular fever.

Other complications of CMV are:

  • Gastrointestinal problems include diarrhea, fever, abdominal pain, colon inflammation, and blood in the stool.
  • Liver function problems.
  • Intricacies of the central nervous system (CNS), such as encephalitis or inflammation of the brain.
  • Pneumonitis or inflammation of lung tissue.

Reference values

Citomegalovirus Inmunoblobina M (CMV IgM)
Negative (reported as positive, negative, or equivocal)

A negative Cytomegalovirus (CMV) IgM results suggest that the patient is not experiencing a recent infection. However, a negative impact does not exclude primary CMV infection.

Cytomegalovirus-specific IgM antibodies have been undetectable in 10% to 30% of umbilical cord blood sera from infants who demonstrated infection in the first week of life.

In addition, up to 23% (3/13) of pregnant women with primary CMV infection showed no detectable IgM responses to CMV within eight weeks after infection.

In cases of primary infection where the time of seroconversion is not well defined, 28% (10/36) of pregnant women did not demonstrate IgM antibodies against CMV.

Positive CMV IgM results indicate a recent infection (primary, reactivation, or reinfection).

IgM antibody responses have been demonstrated in secondary CMV infections (reactivation) in some patients with CMV mononucleosis, pregnant women, and renal and cardiac transplantation patients.

Antibody levels may be lower in transplant patients with secondary rather than primary infections.

 Citomegalovirus Inmunoblobina G IgG:
Negative (reported as positive, negative, or equivocal)

The positive results of IgG against Cytomegalovirus indicate a recent or recent CMV infection.

These people can transmit CMV to susceptible individuals through blood products and tissues.

It is presumed that individuals with negative CMV IgG results have not had previous exposure or infection with CMV and, therefore, are considered susceptible to primary infection.

Conclusion: misleading results of CMV IgM or IgG may occur during acute infection or due to non-specific binding reactions. Present an additional sample for the test if clinically indicated.


Sera taken very early during the acute stage of infection may have undetectable Cytomegalovirus (CMV) IgM or IgG levels.

Immunocompromised patients may have an impaired immune response, and nonreactive IgM / IgG results may be due to delayed seroconversion and not ruling out the current infection.

CMV IgM and IgG results should not be used alone to diagnose Cytomegalovirus infection.

The results should be considered together with the clinical presentation, the patient’s history, and other laboratory findings.

In cases of suspected disease, present a second sample to perform the test in 10 to 14 days.

The performance characteristics of these trials have not been evaluated in immunosuppressant recipients or organ transplants. They have not been established for umbilical cord blood or the analysis of newborns.

These assays should not be used to select blood or plasma donors.

Immune complexes or other aggregates of immunoglobulins present in patient samples can cause an increase in non-specific binding and produce false-positive results.

Possible cross-reactivity for CMV IgM can occur with positive samples for Epstein-Barr virus, viral capsid antigen IgM, and IgM parvovirus B19.

The possible cross-reactivity for IgG against Cytomegalovirus with human chorionic gonadotropin, IgG against HIV, multiple myeloma IgG, rheumatoid factor IgM and Toxoplasma gondii IgG should not be ruled out.