CMV symptoms and treatment in children. If a child is diagnosed with cytomegalovirus (CMV), is treatment necessary and what kind? A short video about how enzyme immunoassay is done

Cytomegaly is considered a common infectious disease. Despite this, most parents do not understand how to treat cytomegalovirus in children. CMV occurs in 50% of all children, and parents, having suffered the infection, are its carriers. Once in the body, the virus remains in it forever, so it is important to understand what it is.

Reasons for appearance

Cytomegalovirus is a type 5 herpes virus that is transmitted only from person to person. None of the other living beings are its carrier. There are several reasons that cause the development of CMV in children:

• Intrauterine infection is the main cause. Infection occurs during pregnancy (before it) as a result of a woman’s illness.
• A high risk of contracting the virus occurs during labor and breastfeeding.

Routes of infection

Cytomegalovirus infection is present in urine, breast milk, blood fluid, saliva, male semen and female secretions.

The mechanism of penetration of the virus into the body and the age of the baby play an important role in the development of the disease. Cytomegalovirus in a child can be congenital or acquired; therefore, there are 3 directions of infection entering the child’s body, shown in the table:

Type of lesion	Transmission path	Peculiarities
Congenital	Antenatal	Deviation brings the most unforeseen consequences
		The concentration of the virus in the amniotic fluid facilitates its penetration into the baby’s vital organs
		Sometimes pregnancy ends in miscarriage
Acquired	Intrapartum	The risk of contracting an infection even with an active form of the disease in the mother is about 5%
	Postnatal	Transmission of infection during breastfeeding accounts for 30 to 70% of all cases
		Infection occurs through kisses and body contact, which is associated with the child’s active communication with strangers

Symptoms of CMV development in children

The virus is transmitted to the fetus through the placenta.

From the moment the infection enters the body until signs of the disease appear, it can take from 15 days to 3 months. The child’s normal immunity will cope with the virus, and cytomegaly will not manifest itself in any way. The activation of the virus is influenced by immunity, age, and the presence of concomitant diseases:

• Congenital cytomegalovirus in children is manifested by the following symptoms:
  • the liver and spleen are enlarged;
  • jaundice;
  • damage to auditory and visual function;
  • developmental delay;
  • the number of platelets in the blood is reduced.
• When infected through breastfeeding, the signs of cytomegalovirus differ:
  • a rash appears;
  • causeless pneumonia;
  • cough;
  • liver inflammation develops.
• Cytomegalovirus infection in a one-year-old child and older children in the acute phase is accompanied by symptoms, as with ARVI and mononucleosis syndrome, as with the Epstein-Barr virus:
  • temperature increase;
  • inflammation of the salivary glands;
  • twisting of joints;
  • headache;
  • runny nose;
  • lack of appetite;
  • fast fatiguability.

Features of the virus for an infant

In newborns, the virus attacks the liver.

Congenital cytomegalovirus infection or acquired in the first months of life affects the development of the baby, threatens disability and is life-threatening. The first days of life after birth are characterized by the manifestation of symptoms of liver damage (yellowness of the eyes and skin). In healthy babies, postpartum jaundice disappears within a month; in children with the virus, it persists for up to six months.

CMV infection is the cause of damage to the hematopoietic function and inflammatory processes in the brain tissue. Due to a decrease in the number of platelets, an infant develops bruises on the body, the navel bleeds and does not heal. And the inflammatory process provokes loss of consciousness, convulsions, disorders of the central and peripheral nervous system.

Virus in immunocompromised children

Cytomegalovirus infection in children with a deficient immune system is truly life-threatening. According to statistics, the number of pathologies with CMV leading to death is greatest in children with immunodeficiency. Treatment of the disease in this case should be intensive and begin immediately. It is important to understand the individuality of each case, so only a specialist should determine therapeutic methods.

Consequences of infection

Cytomegalovirus provokes the development of hepatitis.

It is incorrect to consider cytomegalovirus infection as harmless to children's health. Although it may not appear for a long period of time, the decrease in immune defense causes it to develop rapidly. Intrauterine cytomegalovirus infection in newborns provokes the following complications:

• inflammation of the meninges;
• pathologies of the optic nerves;
• accumulation of fluid in the brain;
• lack of hearing;
• the functioning of the salivary glands and adrenal glands is disrupted.

If the body’s defenses are weakened, CMV penetrates into vital organs, provoking the development of pathologies:

• inflammation of the spinal cord;
• pneumonia;
• hepatitis;
• inflammation of the colon;
• neuropathy;
• inflammation of the retina.

The most dangerous is considered to be asymptomatic childhood cytomegalovirus, infection with which occurred in the prenatal period, during childbirth or breastfeeding. In this case, cytomegalovirus in a newborn is dangerous with serious consequences:

• In 20% of newborns, after some time, deformation of the skull bones, motor dysfunction, convulsions and outwardly noticeable underweight are observed.
• After a few years, developmental delays, speech impairments become noticeable, and cardiovascular pathologies appear.

What is the difference between congenital and acquired citalomegalovirus infections? What symptoms does this disease have and what danger does it pose to the child’s health?

Cytomegalovirus is a widespread disease of a viral nature. Signs of the presence of cytomegalovirus infection are not known to everyone, since, even while in the body, the virus may not actually manifest itself and may not have a negative impact on the overall well-being of the baby. External signs of the disease usually occur when the immune system malfunctions.

Causes of cytomegalovirus in children

Cytomegalovirus is one of 4 types of herpes viruses, which in addition to common herpes include infectious mononucleosis and chickenpox.

During the study of this virus, scientists came to the conclusion that most of the world's population, with the exception of people living in complete isolation from the outside world, are carriers of the disease. The difference is that some people become infected before birth or in childhood, while others become infected already in adulthood.

• During primary infection, cytomegalovirus penetrates the structure of the cells of the child’s body and remains there throughout life, in 80% of cases remaining in a passive state for a long time. The activity of the virus will depend on a person’s lifestyle, starting from childhood
• With proper nutrition, good physical shape, and the absence of stressful situations, the virus may not manifest itself for many years.

Cytomegalovirus infection of the expectant mother affects the health of the fetus

How is cytomegalovirus transmitted in children?

• Infection with this virus occurs through contact with a sick person. Due to the presence of the virus in any kind of body secretions of the virus carrier: saliva, sputum, blood, sweat, urine, feces, semen, breast milk, there is a huge number of chances of being infected
• The virus can be transmitted to a child through dishes, toys, personal hygiene items, dirty hands in kindergartens, schools, hospitals, public transport, at home
• All cases of infection through contact are an acquired type of disease, which is not considered dangerous to the health of the baby.

Citalomegovirus infection through contact with a carrier of the disease

Cytomegalovirus in infants

Intrauterine infection, as well as infection with the virus during childbirth or in the first year of life from a sick mother, for example through breast milk, poses a very great danger to the further development, growth and even life of the child.

Cytomegalovirus poses the greatest threat to:

• Unborn babies whose transmission of the virus occurs through the placenta during fetal development
• Newborns whose immune systems are weak and unable to fight disease

Congenital infection carries a high risk of pathologies of fetal formation: malformations of the brain, dysfunction of the nervous, digestive, and cardiovascular systems, untreatable damage to the organs of vision and hearing, and the musculoskeletal system.

With a congenital form of infection, signs of the disease may not be noticeable immediately, but after several months or even years. Symptoms of the virus in infants are similar to those of other infectious diseases:

• Sealing of lymph nodes
• Enlarged tonsils and laryngeal edema
• Catarrhal phenomena
• Increase in the size of internal organs
• Difficulty in breathing
• Yellowness of the skin and whites of the eyes
• Impaired sucking and swallowing reflexes
• Loose stools, vomiting

Examination of a child by a doctor for symptoms of cytomegalovirus infection

Consequences of cytomegalovirus in children

This type of infection poses the most serious danger in early infancy, as it is often completely asymptomatic. The consequences of the development of the virus in the body of a newborn in cases where the infection occurred in utero or while passing through the birth canal can be very tragic:

• In 15-20% of children with an active asymptomatic form of the disease, some time after infection, skin rashes develop, problems with the central nervous system: convulsions, anxiety, impaired motor function, as well as possible changes in the structure of bone tissue and internal organs, weight loss body
• After a few years, manifestations of late consequences are possible in the form of delayed speech and mental development, pathology of the cardiovascular system, damage to the ocular and auditory apparatus, neuralgia

Symptoms of cytomegalovirus in children

As a rule, if the infection did not occur in infancy or early childhood (over 1 year), then the child’s body, which has already developed a certain immunity, can quite easily cope with the disease.

Sometimes the course of the disease also passes without obvious symptoms. In some cases, citalomegalovirus infection manifests itself like a common ARVI, herpes or rubella. Then the symptoms look like this:

• The child becomes lethargic and drowsy
• There is an increase and thickening of the lymph nodes in the neck area
• Inflammation and swelling of the larynx, signs of sore throat
• Complaints of muscle and joint pain
• Fever, chills, fever
• Possible skin rashes and subcutaneous hemorrhages
• Disturbances in the functioning of the gastrointestinal tract may occur

Complications of the primary symptoms of the disease in rare cases include the development of pneumonia, hepatitis, and neurological abnormalities in behavior.

Symptoms of cytomegalovirus in children are similar to signs of ARVI

Antibodies to cytomegalovirus in a child

• During the initial diagnosis of the disease, specific antibodies are detected in the blood serum ( immunoglobulins) IgG and IgM types
• IgM is synthesized from the moment of infection with the virus. They are recorded already in the first weeks after infection and can remain in the blood for up to 3-5 months. The presence of IgM in the blood serum confirms the primary stage of infection and the initial stage of the disease (presence of the virus in the body for no more than 3-4 months)
• Immunoglobulins IgG begins to be recorded in the blood 1-1.5 months after infection. They remain in the body throughout life, which allows the immune system to cope with increased viral activity
• Detection and control of the amount of antibodies helps to conduct comprehensive monitoring of the child in the dynamics of the development of the disease
• It should be noted that in severe forms cytomegalovirus infections in children, antibody production may be significantly slowed

Conducting a blood test to detect antibodies to the causative agent of cytomegalovirus

Norms of cytomegalovirus in children

• Quantity immunoglobulins to the virus is determined in the process of studying the maximum dilution of blood serum taken from a child for analysis, in which a positive reaction is present. The analysis does not determine the exact number of antibody molecules in the blood, but reflects their overall activity
• To determine the presence of a virus in the body, the concept is used diagnostic titer (dilution degree is 1:100)
• Positive research result, i.e. Exceeding the norm for the presence of antibodies in the blood indicates the development of a viral infection
• The presence of immunoglobin IgM, established as a result of a blood test, is less than 0.5
• If this value is exceeded, the test for CMV infection in the child is positive

Analysis for cytomegalovirus in a child, transcript

If an expectant mother is diagnosed with an acute form of cytomegalovirus during pregnancy, then in the first weeks after the birth of the baby, his blood is tested for the presence of antibodies.

• When interpreting the results, it is taken into account that IgG antibodies recorded in the first 3 months of life are not considered a sign of congenital cytomegalovirus infection, but are a consequence of the presence of the disease in the mother
• Only the presence of IgM antibodies in the child’s blood in quantities exceeding the norm indicates an acute stage of the disease and congenital infection

Research results (immunogram)

What to do if a child is diagnosed with cytomegalovirus?

As noted, testing for the presence of this virus in a baby is carried out if the mother suffered an active form of the disease during pregnancy. Another reason to prescribe an infection test ( immunoenzyme analysis) the symptoms of an infectious disease become mixed in older child. In this case, a detailed blood test is performed for all types of infections.

• If, after ELISA studies, the presence of antibodies to the causative agent of cytomegalovirus is revealed, the attending physician, based on this, must first determine the type of disease - congenital or acquired
• The acquired form, as a rule, is asymptomatic, does not pose any danger or risk of complications for the child, and therefore should not cause panic in parents
• If the disease manifests itself, treatment is carried out according to symptoms depending on the severity of the disease.
• The main concern of parents in this case should be aimed at strengthening the baby’s immunity. Usually prescribed general health complexes - physical exercises, breathing exercises, water procedures, proper nutrition and vitamin intake

Water procedures to strengthen a child’s immunity when suffering from cytomegalovirus

How to treat cytomegalovirus in children?

• Treatment with drugs is prescribed only in cases of congenital infection, as well as in cases of aggravated medical history - severe symptoms, associated complications
• It should be understood that complete elimination of herpes virus infections is impossible, therefore therapy involves stopping the activity of the virus and its accompanying manifestations
• Treatment should be carried out under the mandatory supervision of the attending physician using antibacterial and immunomodulatory therapy
• Along with this, antiherpetic drugs are prescribed, for example, ganciclovir, cytoven in combination with antiviral, analgesic and antipyretic drugs

What to do if a child is found to have cytomegalovirus: tips and reviews

Most parents do not know what kind of scourge this is - cytomegalovirus infection. Although, with a high degree of probability, they themselves have already been ill with this “sore”, and will forever remain its carriers. Why is cytomegalovirus infection dangerous for children? And how to treat cytomegalovirus in a child?

Newborns and children with weakened immune systems suffer the most from cytomegalovirus infection and its consequences.

Cytomegalovirus infection in children: what does herpes have to do with it?

Speaking about cytomegalovirus infection in children, we return to the topic. In essence, cytomegalovirus is a type of herpes virus, and mention of it is found in medical records no less often than mention of the herpes simplex virus.

Medical scientists are convinced: all people on Earth (with the possible exception of those who live their lives, like Robinson, in absolute isolation from other people) are infected with cytomegalovirus. The only difference is that most of the population becomes infected with it in childhood, and the rest - already in adulthood, but no later than 40-45 years.

Like the herpes simplex virus, cytomegalovirus also penetrates the child’s cells during the first infection and remains there for life, for the most part remaining in a “dormant” inactive state. And if a person leads a healthy lifestyle from early childhood, avoids stressful situations, monitors his diet and health (at first, of course, at the suggestion of his reasonable parents), thereby maintaining his immunity in constant “combat readiness,” then cytomegalovirus in his the body can “sleep” indefinitely...

How does cytomegalovirus infection occur?

Cytomegalovirus is transmitted from person to person through contact. And since it is found in any secretions of the human body (saliva, sweat, blood, sputum, feces, urine, semen and breast milk), there are a great many chances of becoming infected. But all of them are acquired in nature and are not considered dangerous to the child’s health.

In both adults and children (usually already several months of age or older), infection with acquired cytomegalovirus occurs practically asymptomatically. And it does not pose any serious damage to health.

However, children can become infected not only in the first years or in the first months of life. But a little earlier! And in this case, the infection can turn into a tragedy...

We mentioned that cytomegalovirus in children can be acquired- and in this case it poses virtually no danger to the baby’s health. But cytomegalovirus can also be present in children congenital(when a child is infected in the womb, at the time of birth, or in the first days after birth). And in this case, cytomegalovirus infection can cause irreparable harm to the child’s health.

For which children is cytomegalovirus most dangerous?

• unborn children whose infection occurs during intrauterine development through the placenta;
• newborn children whose immune system is still weak and unstable;
• children of any age with severely weakened immunity or with its complete absence (for example, against the background of AIDS).

With congenital infection with cytomegalovirus, there is a real risk of damage to the child - with a high degree of probability, developmental defects of the baby, serious disorders in his nervous system, in the digestive system, in the cardiovascular and musculoskeletal systems may occur, and irreversible damage to the organs of hearing and vision is also possible .

Moreover, a baby can “catch” cytomegalovirus, which is dangerous for a baby, not only during intrauterine development, but also during childbirth (by contact with secretions in the birth canal), as well as immediately after birth - when feeding the mother’s breast milk.

Diagnosis of cytomegalovirus infection in children occurs through laboratory analysis, which can be carried out in several ways. In Russia today the most common method is the so-called ELISA method - enzyme-linked immunosorbent assay. Moreover, it is important to find out not only the presence of the virus in the body, but also to determine its form - whether it is congenital or acquired.

When a cytomegalovirus infection develops in children during the neonatal period, then in this case its symptoms are usually similar to those - the lymphoid tissue suffers, which can be expressed in enlarged lymph nodes, inflammation of the tonsils, an increase in the size of the liver and spleen, and difficulty breathing. Also among the symptoms of congenital cytomegalovirus infection are often found:

• impaired swallowing and sucking reflexes.

And if the baby has difficulty breathing through his nose, the following will naturally be added to the symptoms:

• loss of appetite and weight loss;
• lack of restful sleep;
• crying and worry.

At different stages of pregnancy, the expectant mother undergoes a lot of tests. Including cytomegalovirus. If before the start of the “interesting situation” or in the first weeks of pregnancy, the analysis showed the presence of mature antibodies to cytomegalovirus, this woman can calmly rejoice, without fear of anything. She herself is protected, and will be able to protect her child from this infection. The most dangerous situation: if a woman does not have antibodies to cytomegalovirus at the beginning of pregnancy. The probability of encountering him within 9 months is extremely high, but for her this meeting will be absolutely safe, but for her unborn baby it can pose the greatest risks...

And despite the fact that congenital infection of the baby occurs even before birth (or during childbirth, or immediately after birth), the symptoms of cytomegalovirus infection may not appear immediately, but even 1-2 months after birth.

Cytomegalovirus infection in children acquires its most severe forms during intrauterine infection. Alas, even in this case, the disease may be asymptomatic - and then not only parents, but even doctors may not immediately suspect that the baby has a serious illness that threatens serious consequences.

Possible complications of asymptomatic development of cytomegalovirus in infants

Perhaps this is one of the most terrible and dangerous situations in the life of a baby and his parents - when the baby develops a serious illness, but no symptoms are observed. Unfortunately, sometimes cytomegalovirus infection develops in exactly this scenario in young children.

In this case, the consequences can be very sad. For example:

• About 20% of children with active cytomegalovirus, but an asymptomatic form of the disease, several months after infection show severe convulsions, disturbances in motor activity, changes in the skull skeleton, and clearly insufficient body weight.
• And after 4-5 years, approximately half of these children show obvious impairments in speech and mental development, as well as serious problems in the functioning of the cardiovascular system. Some children begin to rapidly lose their vision.

How does cytomegalovirus occur in children older than the neonatal period?

If the infection is acquired and the infection itself occurs when the baby has already passed the neonatal stage, the child, as a rule, easily copes with the disease: the infection is almost always asymptomatic, and only in some cases can it resemble.

Symptoms may include:

• lethargy and drowsiness;
• enlarged lymph nodes (especially in the neck);
• muscle and joint pain;
• chills and slight fever.

As a rule, the acute period of the acquired form of cytomegalovirus infection in children lasts from 2 weeks to 2 months. But most often it goes unnoticed. In some cases, the disease requires medical supervision, but almost always goes away on its own, without any specific treatment. However, let us remind you: this applies specifically to the acquired form of the disease - when the baby became infected long after birth, having managed to accumulate a certain supply of the body’s immune defense by the time of infection.

Only in the rarest cases does the acquired form of cytomegalovirus cause any serious complications. And in the vast majority of cases, the disease passes without a trace.

But if your child, 2-3 months after the diagnosis of cytomegalovirus infection, still has obvious signs of mononucleosis (enlarged lymph nodes, adenoids and inflamed tonsils, constant lethargy and fatigue, sometimes increased salivation and a whitish coating on the oral mucosa), it is imperative to consult a doctor.

Treatment tactics for cytomegalovirus in children

Drug treatment for cytomegalovirus infection in children is carried out only in cases of congenital infection, as well as in severe forms of the disease.

As in the case of the herpes simplex virus, treatment of cytomegalovirus infection in children does not imply total ridding of the body of viruses - this is simply impossible. Treatment comes down to “quenching” the activity of the virus and avoiding possible negative consequences. Most often, antiherpetic drugs such as cytovene or ganciclovir are used to treat cytomegalovirus infection.

As in the case of other herpes infections, drug therapy can in no case be prescribed independently - any medicine against herpes (including against cytomegalovirus) should be used strictly as prescribed by a doctor, and not by a neighbor, an erudite relative or online bloggers!

In a word - about the most important

Among the sea of ​​information, it will be useful for parents to “fish out” and remember several particularly important facts about cytomegalovirus infection:

1. The cytomegalovirus itself, being present in human cells in an inactive state, remains invulnerable to any drugs - it is impossible to kill or “drive” it out of the body. A person (most often a child), who becomes infected with cytomegalovirus, remains a carrier for life.
2. For adults and children over 1 month of age, cytomegalovirus infection in the vast majority of cases does not pose any threat to health - it is asymptomatic and without consequences.
3. Infection with cytomegalovirus is truly dangerous for people (and children) with weakened immune systems or obvious immunodeficiency, as well as for newborn babies (who could have become infected in utero or during childbirth), as well as for pregnant women. And only for those expectant mothers who become infected with cytomegalovirus for the first time during pregnancy.
4. It is possible to detect cytomegalovirus infection only with the help of special tests, which are extremely rare - after all, in most cases the disease is asymptomatic. Consequently, a huge number of people do not even suspect that they themselves, or their children, have had CMV infection.
5. In patients with immunodeficiency, as well as in newborn babies, the infection often takes on a generalized form, the symptomatic picture of which has its own characteristics - the course of the disease is very similar to mononucleosis: the tonsils become inflamed, the lymph nodes increase in size, the temperature can rise to 39 ° C, signs of sore throat and pneumonia, etc. Symptoms of jaundice may occur due to liver damage. At the first suspicion of mononucleosis, in this case it is necessary to do an analysis for cytomegalovirus.
6. Congenital cytomegalovirus infection is the most dangerous. But it does not affect all newborn babies, but only about 10% of them. The rest recover asymptomatically and without negative consequences.
7. The course of cytomegalovirus infection in newborn babies is symptomatically similar not only to mononucleosis, but also to other infections - for example, herpes simplex, rubella and toxoplasmosis. Therefore, as a rule, when symptoms of one of these diseases appear, an analysis is done immediately for everything.
8. The sooner the analysis is carried out and the presence of infection is detected, the greater the chances of a quick recovery without consequences. If treatment is started in the first 7-9 days after infection, almost all of the catastrophic consequences of cytomegalovirus infection can be avoided. The most common type of analysis for cytomegalovirus is an ELISA test (enzyme-linked immunosorbent assay).

According to WHO, mortality from the generalized form of cytomegalovirus infection worldwide currently ranks second in the viral diseases sector after mortality. However, you always have all the means at your disposal: information, diagnostic and treatment options to protect your children or yourself from any negative consequences of “communication” with cytomegalovirus...

The disease, which is caused by the Herpesviridae virus, is similar to the herpes simplex virus. When multiplying in a cell, the cytomegalovirus virus in children leads to the formation of huge cells due to an increase in the nucleus and cytoplasm. This is a disease with polymorphic symptoms.

In general, CMV infection in children is transmitted without obvious signs. Viruses are resistant to antibiotics. Transmission occurs mainly by contact, less often by airborne droplets. Placental and parenteral (through blood) routes of transmission are possible. Fetuses and newborns are especially susceptible to the disease. Newborns can become infected through breastfeeding from their mother. The CMV virus in children is detected in saliva, cerebrospinal fluid, urine and organs.

CMV infection in children can occur due to the penetration of viruses through the placenta or during childbirth. However, not all infected children may be born with severe signs of the disease. Most often it occurs latently. Only in the salivary glands can cell changes occur (giant cell metamorphosis).

If a child is diagnosed with cytomegalovirus, but there are no symptoms, it is possible that parents should not worry. With good immunity, the virus does not pose a danger. If the disease is latent, the child will develop immunity, and the body itself will cope with the infection without consequences. But sometimes a latent infection can lead to some disorders of the central nervous system. The child develops headaches, mental retardation, insomnia, and fatigue.

Sometimes exposure to infection can cause serious complications. If the immune system is weakened and cytomegalovirus is found in the child, this is a signal to begin active therapeutic measures. With severe immune deficiency, infection leads to an unfavorable outcome.

At what age can cytomegalovirus appear in children?

Congenital cytomegalovirus in a child occurs when the placenta is damaged and the infection is generalized. If infection occurs in the first months of intrauterine development, developmental defects are possible. The child may have hydrocephalus, microcephaly, or a disorder of the structure of the brain substance. On the part of the cardiovascular system, there may be non-closure of the septum of the heart, endocardial fibroelastosis, and heart defects. Sometimes defects of the kidneys, genitals and gastrointestinal tract may appear.

If infection occurs late in life, cytomegalovirus in newborns shows symptoms after birth. The child develops jaundice, damage to the lungs and gastrointestinal tract, and hepatoleanal syndrome are detected. Sometimes the disease can manifest as hemorrhagic rashes. With CMV, newborns experience lethargy, frequent regurgitation and diarrhea. Because of this, children do not gain weight well, they have decreased tissue turgor, and increased temperature.

Jaundice may appear during the first two days. Most often it is pronounced, since there is a very high concentration of bile pigments in the blood. The child's feces are partially discolored, the spleen is enlarged, and the liver protrudes 37 cm from under the costal arch. Hemorrhagic syndrome can manifest as petechiae and vomiting. In children, hypotonia and hyporeflexia are determined. In severe cases, intoxication develops, leading to death.

Cytomegalovirus infection in an infant can be congenital or acquired. The disease in its congenital form is much more severe, since the virus manages to cause significant harm to the child’s body while still in the womb. But even when the virus is transmitted to the fetus, only 10% of children are born with obvious signs of the disease. Often cytomegalovirus does not appear in infants.

The nature of the development of the disease depends on the maturity of the fetus at the time of intrauterine infection, the mother’s immunity and the child’s immune reactivity. Symptoms of congenital CMV in an infant may include: jaundice, convulsions, abnormal development of organs and systems. Doctors can diagnose deafness and blindness.

Acquired cytomegalovirus in children under one year of age can manifest itself as damage only to the salivary glands. In response to the introduction of the virus into cells, severe dysfunction of the affected organ may occur. In severe cases, cytomegalovirus in an infant can cause adrenal insufficiency, and in case of immunosuppression, damage to all organs.

Acquired cytomegalovirus in a 1-year-old child can manifest itself as a delay in physical development. In this case, disturbances in motor activity and convulsions are observed. Depending on the state of the child’s immunity, various signs may appear: swelling of the salivary glands, hemorrhages, blurred vision, damage to the gastrointestinal tract. But more often the acquired disease can be asymptomatic.

Cytomegalovirus in a 2-year-old child can lead to either isolated damage to the salivary glands or organ damage. However, unlike the congenital form, the disease more often manifests itself as mononucleosis. The child may experience a gradual increase in temperature, sore throat, enlarged lymph nodes, hepatosplenomegaly, swelling of the throat mucosa, and abdominal pain.

The immune system of children under 5 years of age is not yet capable of providing an adequate response to infection. Cytomegalovirus in children 3 years of age may present with symptoms of interstitial pneumonia. The child develops shortness of breath, whooping cough-like persistent cough, and cyanosis. Possible addition of dysfunctions of the gastrointestinal tract and liver. Temperatures can reach 40 degrees. This condition can last from 2 to 4 weeks.

In the generalized form, almost all organs can be involved in the process. The disease is manifested by sepsis, prolonged fever, disorders of the gastrointestinal tract and cardiovascular system, parenchymal hepatitis and encephalitis. For complications of CMV in children aged five years, treatment includes the administration of immunoglobulins (Interferon) in the complex of measures. After five years, the child’s body is able to cope with the infection on its own without serious consequences.

What are the symptoms and signs of infection in children?

If cytomegalovirus affects, symptoms in children may appear depending on age and immune status. The older the child, the easier the disease will be tolerated. At the first encounter with the virus, children under 7 years of age with normal immunity develop typical symptoms:

• Hyperthermia
• Swelling of the larynx, inflammation
• Muscle weakness, malaise
• Headache

Sometimes there may be rashes on the body. If children have symptoms of cytomegalovirus, treatment is carried out with antiviral drugs, which transfer the disease to a passive form.

In case of decreased immunity, symptoms of CMV in children may appear depending on the organ damage or the form of the disease. The virus affects the intestinal glands, bile ducts, kidney capsules, etc. This leads to the occurrence of focal inflammation. Pneumonia, bronchitis, inflammation of the spleen, adrenal glands, and liver may develop. In the generalized form, all organs can be affected. In this case, the symptoms of CMV infection in children are polymorphic. The generalized form is severe and can be fatal in the first 2 weeks of life. In isolated forms of damage to any organ, it can be asymptomatic.

When is treatment for a disease necessary?

Treatment of cytomegalovirus in children involves the use of a complex of drugs depending on the affected systems. In the generalized form, the administration of corticosteroids, antiviral (Ganciclovir) and specific Cytotect is indicated. In order to restore the basic functions of the immune system (primarily the production of interferon), a course of treatment is carried out with interferon inducers (amixin, Cycloferon). These drugs activate humoral and cellular immunity. Thanks to interferons, the immune system begins to work effectively and contributes to the death of the virus.

Most often, treatment of CMV in children is carried out with the prescription of human immunoglobulin (Megalotect, Cytotect). These drugs are non-toxic and can be used to treat children of any age. In exceptional cases, more toxic antiviral drugs are prescribed for the treatment of newborns - Ganciclovir, Cidofovir. This therapy is carried out in cases of severe damage to visceral organs. However, before treating cytomegalovirus in a child with toxic drugs, the degree of complications caused by the virus should be assessed. The therapy itself and the set of drugs used for treatment must correspond to the child’s immune status.

Virus carriage itself or a mild disease (mononucleosis syndrome) in children with normal immunity does not require therapy. It is enough to use vitamins and restorative drugs to strengthen the immune system. During periods when outbreaks of infectious diseases (flu or acute respiratory infections) occur, the use of multivitamin complexes will protect the child from the virus.

How dangerous is cytomegalovirus in a child?

Usually healthy children tolerate this infection normally. The disease can be asymptomatic or with symptoms of a cold that disappear after a few days. However, in weakened children, this infection can occur with complications. The consequences of cytomegalovirus in a child can appear either immediately after birth or after previous illnesses. Asymptomatic progression may in the future cause visual impairment or mental retardation. Hearing problems or neurological abnormalities may develop over time.

Scientific studies have established the danger of fetal infection in the first half of pregnancy. Having penetrated the body, the virus exhibits a teratogenic effect. As a result, the development of the brain, hearing and vision organs, and visceral organs is impaired.

Analysis for cytomegalovirus in a child

In order to make an accurate diagnosis, you should be tested for cytomegalovirus. Several methods are used for diagnosis:

1. Virological (cytological).
2. Serological. The most accessible ELISA method is the isolation of immunoglobulins G and M.
3. Molecular biological (PCR).

The most informative test for CMV in a child is the PCR method. It is possible to detect not only CMV DNA using PCR in children, but also the activity of the virus. However, this method is one of the most expensive. Another method is used that allows one to establish antibodies to cytomegalovirus in a child - serological (ELISA). The analysis determines several types of antibodies and the stage of the disease.

There are some differences in antibodies to understand. Class M immunoglobulins are produced in response to the virus. They cannot form immunological memory, so when they disappear, protection against the virus disappears. Immunoglobulins G are produced after suppression of infection throughout life, developing stable immunity to the disease.

If anti-CMV IgG is detected in a child, but anti-CMV IgM is not detected, this indicates that the body has developed lifelong immunity to the virus. That is, this is the norm for CMV in children, which does not require treatment. If cytomegalovirus igg is positive in children, but anti cmv ​​IgG antibodies are not detected, the analysis shows that the body does not have stable immunity to the virus. Antibodies suppress the development of the virus and help transmit the disease without symptoms. If a child does not have antibodies to cytomegalovirus (cmv g), this is explained by the absence of the disease or high susceptibility to infection.

Cytomegalovirus (cmv, CMV) igg positive in a child indicates that he is infected either before birth or after. If a child has a very high titer, this is evidence of infection activation. This usually increases the concentration of iGM antibodies.

Antibodies to cytomegalovirus igg are positive in the child - this means that the disease is either in an inactive stage or in the reactivation stage. The readings of class M antibodies help to give an accurate analysis. If anti CMV igg is positive in a child and Anti CMV IgM is positive, this means that the end of the primary infection is occurring in the body, and immunity has already formed. If IgM is negative, the disease is in an inactive stage.

A positive cytomegalovirus igM in a child with a negative Anti-CMV IgG indicates a primary disease in the acute stage. If the tests do not detect antibodies of both classes, it means either the disease is absent or it is at an early stage and antibodies have not had time to develop.

Cytomegalovirus is one of the most common infectious agents in the human population, and is found in more than half of children worldwide at one age or another.

The penetration of the virus into a child’s body usually does not pose a particular danger, since most often it is asymptomatic and does not require treatment. However, danger arises when infection occurs during gestation, the first weeks after birth, or a significant decrease in the activity of the baby’s immune system...

Penetration of the virus into the child’s body

In the development of cytomegalovirus infection, the mechanism of introduction of the virus and the age of the child play a special role.

There are the following ways of penetration of cytomegalovirus into the child’s body:

• antenatal (through the placenta during intrauterine development);
• intrapartum (during childbirth);
• postnatal (after birth).

The most severe consequences for a child’s health occur when infected through the placenta. In this case, the virus is in the amniotic fluid and enters in large quantities into the child’s digestive system and lungs, from where it penetrates almost all organs and tissues.

When an expectant mother is initially infected during pregnancy, the probability of the virus entering the amniotic fluid reaches 50%.

Sometimes during pregnancy there is a decrease in the body’s overall resistance, against the background of which a latent infection may worsen. However, the mother’s body already has specific antibodies that reduce the risk of infection of the fetus to 2%, and also protect the unborn child’s body from the development of severe complications.

If the mother has antibodies to the virus without any signs of disease, the risk of developing a congenital infection in the child is practically absent.

Primary infection or activation of a chronic infection in the mother in the 1st and 2nd trimesters of pregnancy poses the greatest threat to the health of the developing fetus, and sometimes leads to miscarriage. During this period, the fetus does not produce its own antibodies, and maternal antibodies are not enough for effective protection. In the third trimester, the fetus develops its own antibodies of classes M and G, so the risk of complications is minimal.

Infection during childbirth plays a minor role in the transmission of cytomegalovirus: the probability does not exceed 5% when a child is born to a mother with an active infection.

In the postnatal period, babies can become infected from their parents through kissing and other close contact. When feeding infected mothers with milk, the virus is transmitted to the child in 30-70% of cases.

Most often, infection occurs between the ages of 2 and 5-6 years. During this period, the child usually attends preschool institutions, where there is a high probability of transmission of the pathogen from staff and from other children. In carriers, the virus can be present in the blood, saliva, urine, and other secretions and can be transmitted through close contact, sneezing, poor hygiene, or sharing toys. The incidence of infection in preschool institutions is 25-80%. The virus can be actively released from an infected human body for about two years.

Cytomegalovirus infection in children aged 2 to 6 years is most often asymptomatic and does not lead to any negative consequences. After 5-6 years, the activity of the immune system in children becomes stable, and the potential risk of developing severe cytomegaly decreases to almost zero.

Cytomegalovirus infection in newborns

There are congenital and acquired forms of CMV infection.

The congenital form occurs during intrauterine infection of the fetus and has a more severe course. Despite the high frequency of transmission of the virus from a sick mother to the fetus, only about 10% of children are born with congenital infection. Of these, more than 90% have no signs of the disease.

Symptoms of congenital infection include prematurity, jaundice, drowsiness, and difficulty swallowing and sucking. Enlargement of the spleen and liver, convulsions, strabismus, blindness, deafness, microcephaly, hydrocephalus are often observed. Sometimes abnormalities in the development of the cardiovascular, digestive and musculoskeletal systems are detected.

The absence of these symptoms in a newborn with suspected congenital CMV infection does not indicate the health of the child. There may be a late manifestation of the disease in the first 10 years of life in the form of mental retardation, impaired tooth formation, decreased visual acuity and hearing.

Acquired infection develops when infected during childbirth and in the first weeks of life. Symptoms of the disease appear 1-2 months after birth. There is a lag in mental and physical development, decreased or increased motor activity, convulsions, swelling of the salivary glands, blurred vision, and subcutaneous hemorrhages. Pneumonia, pancreatitis, diabetes, and hepatitis may develop. However, in most cases, acquired infection is asymptomatic and becomes latent.

Normal course of the disease in children

As a rule, the child’s body copes quite effectively with cytomegalovirus without any external manifestations. In some cases, mononucleosis-like syndrome occurs. Its main symptoms are similar to ARVI: fatigue, pain in muscles and joints, headache, chills, fever, runny nose. Sometimes there is an enlargement of the lymph nodes, increased salivation, a whitish coating on the gums and tongue.

The disease lasts from two weeks to two months. The duration of symptoms may serve as an indirect indication of CMV infection. Hospitalization and specific treatment are not required.

Sometimes encountered complications

Lack of control over the course of infection in an apparently healthy child with suspected congenital infection can lead to delayed onset of complications.

Approximately 17% of asymptomatic children infected with cytomegalovirus experience seizures, movement disorders, abnormal skull sizes (micro- or hydrocephalus), and low body weight several months after birth. At the age of 5-7 years, 10% of children develop disorders of the nervous system, speech impairment, mental retardation, and underdevelopment of the cardiovascular system. About 20% of children at this age rapidly lose their vision.

Acquired infection most often does not cause severe complications. However, if you observe symptoms of a mononucleosis-like disease for more than two months, you should consult a doctor.

Forms of CMV infection and their features

The first entry of CMV into the body causes a primary infection. With normal activity of the immune system, it is asymptomatic, with a reduced immune status it is acute, with signs of mononucleosis-like syndrome. Liver damage and pneumonia may also be recorded.

With a weakened immune system, recurrent infections develop. It manifests itself in the form of frequent bronchitis, pneumonia, multiple inflammation of the lymph nodes, chronic fatigue and general weakness. Inflammation of the adrenal glands, kidneys, pancreas, and spleen may develop. In severe relapses, the fundus of the eye, retina, intestines, nervous system, and joints are affected. Bacterial infections are often observed.

The atypical course of cytomegalovirus infection is rare and can manifest itself as small skin rashes, damage to the reproductive system, paralysis, hemolytic anemia, abdominal dropsy, decreased blood clotting, enlarged ventricles of the brain or the formation of cysts in them.

How to identify cytomegalovirus in a child: diagnostic methods

Diagnosis of CMV infection is possible using several methods:

• cultural: isolation of the virus in human cell culture. The method is the most accurate and allows you to determine the activity of the virus, but takes about 14 days;
• Cytoscopic: detection of characteristic owl-eye giant cells in urine or saliva. The method is not informative enough;
• Enzyme-linked immunosorbent assay (ELISA): detection of immunoglobulin M (IgM) in the blood indicates primary infection. If immunoglobulin G (IgG) is detected, re-examination is carried out at intervals of at least two weeks. An increase in antibody titers indicates activation of the infection. It is possible to obtain false positive results;
• Polymerase chain reaction (PCR): a fast and accurate method that reveals the DNA of the virus and how quickly it multiplies in the body.

The most common is enzyme immunoassay. When using it, it is necessary to determine several types of antibodies at once, which makes it quite expensive. However, this allows the stage of infection to be determined. The accuracy of the method is about 95%.

The PCR method is not available to every laboratory due to its high cost, but if possible, preference should be given to it due to its high accuracy (99.9%).

A short video about how enzyme immunoassay is done

Features of infection control

With asymptomatic CMV and mononucleosis-like syndrome, treatment is not required. In the second case, drinking plenty of fluids is recommended to reduce signs of intoxication.

Treatment is necessary if congenital infection symptoms or complications are severe. The list and dosage of medications is determined by the doctor, taking into account the severity of the disease, age and body weight of the child. Antiviral drugs are used for treatment: Ganciclovir, Viferon, Foscarnet, Panavir, Cidofovir. As well as immunoglobulin preparations - Megalotect and Cytotect.

Self-treatment is strictly contraindicated due to the high likelihood of developing severe side effects.

A few words about prevention

There are no specific means of preventing cytomegalovirus infection. The vaccine is under development.

To protect the child from the possible consequences of infection, it is necessary, first of all, to take pregnancy planning seriously. The expectant mother should be tested for the presence of specific antibodies. If there is no immunity to the virus, a pregnant woman must use separate utensils, avoid frequent contact with small children, and carefully observe personal hygiene rules. During pregnancy, it is necessary to be tested twice for the presence of antibodies to the virus for the timely detection of a primary infection or relapse of a chronic one.

In the first months after birth, the child should be protected from close contact with adults and children under 6 years of age, and kissing the newborn should be avoided. 2-3 months after birth, the child’s immune system is already able to protect him from the development of severe forms of infection, so in the future it is only enough to provide the baby with adequate care. After 6 years, the formation of the immune system is completed. From this age, the body of a normally growing child is able to effectively cope with cytomegalovirus without developing clinical manifestations.

In the future, it is enough to instill in the baby the necessary hygiene skills, provide a balanced diet and harden the body.