CMV是一种普遍存在的DNA病毒,可建立感染并导致40-100%的血清阳性。病毒复制发生在获得性原发感染(或再感染)后或通过终生潜伏期的重新激活而发生。在有免疫能力的患者中,CMV感染大多无症状或轻度和自限性。然而,对截至2024年4月发表的文献的广泛回顾表明,尽管免疫能力,CMV可以在胃肠道的任何部位引起非常多的临床综合征(最常见的模式),中枢或周围神经系统,和眼睛,以及血液学,肺,心脏,和皮肤疾病。并非罕见,涉及不止一个系统,尽管这种疾病通常是自我限制的,可能需要静脉注射更昔洛韦或口服更昔洛韦治疗,在孤立的情况下,死亡可能发生。因此,在非免疫功能低下患者的多种综合征的鉴别中,应考虑潜在的CMV感染.相关的全身症状(发烧,出汗,和体重减轻),淋巴细胞增多,和肝炎并不少见,可以是一个有用的线索。一些人口,例如重症监护的危重病人,孕妇,老年患者,那些患有炎症性肠病的人,可能更容易受到影响。此外,过去的潜力,潜伏性CMV感染(即,CMV血清阳性)与几年后的重大心血管疾病发病率和全因死亡率有关,这很有趣,需要进一步研究。所有这些数据表明开发针对CMV的疫苗的突出重要性,希望在可预见的将来可以使用。同时,通过广泛可用的血清学测试和PCR扩增,可以快速建立(或排除)活动性CMV感染的可靠诊断,所有学科的临床医生都需要更加了解CMV感染的各种形式,并记住在任何宿主中都要考虑它,包括有免疫能力的.
CMV is a ubiquitous DNA virus that establishes infection and results in 40-100% seropositivity. Viral replication occurs following an acquired primary infection (or reinfection) or by the reactivation of life-long latency. In immunocompetent patients, CMV infection is mostly asymptomatic or mild and self-limited. However, an extensive review of the literature published up to April 2024 reveals that despite immunocompetence, CMV can cause a very large variety of clinical syndromes in any part of the gastrointestinal tract (the most common pattern), the central or peripheral nervous system, and the eyes, as well as hematological, pulmonary, cardiac, and cutaneous disease. Not uncommonly, more than one system is involved, and though the disease is often self-limited, treatment with intravenous ganciclovir or oral valganciclovir may be required, and in isolated cases, fatalities may occur. Thus, a potential CMV infection should be considered in the differential of myriad syndromes in non-immunocompromised patients. Associated systemic symptoms (fever, sweats, and weight loss), lymphocytosis, and hepatitis are not uncommon and can be a useful clue. Some populations, such as critically ill patients in intensive care, pregnant women, elderly patients, and those with inflammatory bowel disease, may be more susceptible. Moreover, the potential of past, latent CMV infection (i.e., CMV seropositivity) to be associated with significant cardiovascular morbidity and all-cause mortality years later is intriguing and requires further study. All these data indicate the outstanding importance of developing a vaccine against CMV, which hopefully will become available in the foreseeable future. Meanwhile, a solid diagnosis of active CMV infection can be quickly established (or ruled out) by widely available serology tests and PCR amplification, and clinicians in all disciplines need to be more aware of the diverse guises of CMV infection and remember to consider it in any host, including an immunocompetent one.