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[Acquired cytomegalovirus infections in immunocompetent adults: 116 cases]
J F Faucher1, B Abraham, M Segondy
1Service des Maladies infectieuses et tropicales, Hôpital Gui de Chauliac, Montpellier.
Insights
Cytomegalovirus (CMV) infection in immunocompetent individuals is common and usually mild, with fever, headache, and myalgia being frequent symptoms. Early diagnosis and avoiding unnecessary hospitalizations are key for managing this viral infection.
Area of Science:
- Infectious Diseases
- Virology
- Immunology
Background:
- Cytomegalovirus (CMV) is a common virus with a high prevalence in the general population.
- While often asymptomatic, CMV can cause significant illness in immunocompromised individuals.
- Understanding CMV infection in immunocompetent hosts is crucial for accurate diagnosis and management.
Purpose of the Study:
- To retrospectively analyze the clinical, biological, and epidemiological characteristics of cytomegalovirus (CMV) infection.
- To describe the presentation and outcomes of CMV infection in immunocompetent patients.
- To identify potential areas for improved diagnostic approaches and patient management.
Main Methods:
- Retrospective analysis of 116 cases of CMV infection diagnosed between 1981 and 1997.
- Inclusion of both inpatient and outpatient data from a university hospital setting.
- Diagnosis primarily established using serological criteria.
Main Results:
- Fever was nearly universal (99%), with a mean duration of 21 days; headache (51%) and myalgia (46%) were common symptoms.
- Splenomegaly (36%) was the most frequent sign; pulmonary interstitial opacities were noted in 8.5% of patients.
- Elevated liver enzymes (ALAT, LDH) and mononucleosis symptoms were observed in most cases (85-95%); viremia was detected in 79%.
Conclusions:
- CMV infection in immunocompetent hosts is generally a frequent, self-limiting illness with a low complication rate.
- The utility of pp65 antigenemia for diagnosis in this population warrants further investigation.
- Many hospitalizations for CMV infection in immunocompetent individuals may be preventable with timely diagnosis and appropriate management.
Objective:
To analyse retrospectively the clinical, biological and epidemiological features of cytomegalovirus (CMV) infection in the immunocompetent host.
Patients And Methods:
A retrospective study was conducted in 116 cases of CMV infection (74 inpatients, 42 out-patients) collected from 1981 to 1997 in a university hospital. Diagnostic was established on serological criteria in all cases.
Results:
Fever was observed in all cases but one (mean duration: 21 days). The most frequent symptoms were headache (51%) and myalgia (46%). Splenomegaly was the most frequent sign (36%). Pulmonary interstitial opacities on chest x-ray were found in 8.5% of patients. Pulmonary (1 case) and neurological (2 cases) complications occurred. Concomitant HIV primary infection was observed in 2 patients. Mononucleosis and ALAT and LDH elevations were observed in 95%, 85% and 95% of cases respectively. Viremia was positive in 79% (30/38). pp65 antigenemia was useful to establish the diagnosis in 9 patients. Antibiotics were prescribed in 46% before diagnosis was established.
Conclusion:
CMV infection in the immunocompetent host is a frequent and rarely complicated disease. pp65 antigenemia should be evaluated more in this setting. Most hospitalizations due to this affection could be avoided.