CMV infection in the normal host

Approximately 95 percent of initial CMV infections in healthy pregnant women are clinically silent (Peckham et al., 1983; Griffiths and Baboonian, 1984; Stagno et al., 1986; see also Table 6.1). The proportion that is symptomatic may be

Table 6.1 Primary CMV infection in pregnant women is usually clinically silent

Study*

Sample size

No. primary CMV infections

No. with symptoms (%)

Stagno, 1986

5,199

63

3 (4.8%)

Griffiths, 1984

10,847

58

2 (3.4%)

Peckham, 1983

14,789

28

0

*The combined enrollment of the listed studies included nearly 30,000 women (including seronegative and seropositive participants). There were 149 primary infections identified during pregnancy, but symptoms occurred in only five women with primary infection.

*The combined enrollment of the listed studies included nearly 30,000 women (including seronegative and seropositive participants). There were 149 primary infections identified during pregnancy, but symptoms occurred in only five women with primary infection.

lower in the general population than in pregnant women, considering the fact that almost everyone acquires CMV yet symptomatic primary infection is uncommon. When initial CMV infection is symptomatic, it causes a mononucleosis-like syndrome similar to that associated with Epstein-Barr virus. Symptomatic CMV infection in the normal host is characterized by high fever that persists for more than a week, pharyngitis and lethargy; anorexia, adenopathy, and enlargement of the liver and spleen are also sometimes present. Laboratory abnormalities include anemia, thrombocytopenia, and elevated hepatic transaminases.

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