Cytomegalovirus in a child - symptoms and treatment, what could be the consequences of CMV infection. Cytomegalovirus infection: symptoms in children and treatment CMV test detected in a child

Cytomegalovirus infection (CMVI) is a viral infectious disease. It is caused by a DNA-containing virus - Cytomegalovirus hominis, belonging to the herpesvirus family, which includes Epstein-Bar, chickenpox and others. The CMVI virus can be found in various parts of the human body, however, CMVI is most likely to settle in salivary glands Oh.

The causative agent of the disease, after entering the human body, multiplies in the cells of the infected. CMVI is species-specific for humans, characterized by slow replication, reduced virulence, low interferon-producing activity. The virus is thermolabile, but retains virulence at room temperature.

What is dangerous cytomegalovirus in children

When a child is healthy, cytomegalovirus often does not manifest itself. However, the virus is deadly for people with immunodeficiencies: HIV patients, people with transplants, expectant mothers and newborns. After infection, the cytomegalovirus virus can remain hidden in the body for a long time (latent form). A person will practically not be able to suspect the presence of this infection, but he is a carrier of cytomegalovirus. Cytomegalovirus provokes such life-threatening complications as: inflammation of the brain (encephalitis); disease respiratory system(e.g. pneumonia viral nature); inflammatory and viral diseases in the digestive tract (enterocolitis, hepatitis) and so on.

The worst outcome of the latent course of CMVI is malignant neoplasms.

This viral disease affects both children and adults. The child is often infected while still in the womb, through the uterus or placenta. When primary CMVI infection occurs on early dates pregnancy, this can quickly lead to the death of the fetus, at a later date - the child continues to grow, but CMVI, in one way or another, affects the quality of its intrauterine development. Congenital cytomegalovirus infection may develop, or infection may occur during childbirth. If the infection recurs, the risk of infection of the fetus is lower, but treatment is required. In accordance with each specific case, it is necessary to develop a suitable tactic for managing pregnancy.

Cytomegalovirus infection in a child: symptoms and treatment

Cytomegalovirus in children is widespread on the planet, but it is somewhat more common in developing countries with low level life. The virus is found in a variety of biological fluids human body: in the composition of blood, saliva, urine, breast milk, vaginal secretions and semen. Once in the body, the pathogen remains there for the rest of its life. Usually, CMVI infection is not visible externally.

The manifested signs of the disease in infants are very similar to the symptoms of a common cold: fatigue, fever, inflammation in the pharynx, hypertrophy of the tonsils.

Usually, when good condition immunity, cytomegalovirus is in a latent form, without manifestation of any clinical signs. Whereas during the period of reduced immunity, generalized forms of the disease develop.

Congenital cytomegalovirus in a child: symptoms

Clear signs of intrauterine infection with cytomegalovirus do not appear immediately after the baby is born, but only at 3-5 years of age. In addition, in children under one year old, infection with cytomegalovirus occurs through close contact both from relatives with whom the child lives and from peers in various preschool institutions.

Both in children and in adults, the manifestations of CMVI often look like an ordinary acute respiratory disease. Symptoms are usually as follows: runny nose, fever, swollen lymph nodes, swelling of the throat, sometimes pneumonia, severe fatigue, manifestations of disorders in the endocrine glands, liver, and gastrointestinal tract.

Another of the consequences of cytomegalovirus is the disease mononucleosis, accompanied by fever, weakness, and fatigue. In the most severe cases, the disease affects all major organs.

Congenital infection with CMVI in a child leads to disturbances in physical and mental development. In addition, cytomegalovirus often leads to death, diseases in the perinatal period and delayed disorders in organs and systems. About 40-50% of newborns from mothers who were initially infected with CMVI during gestation have intrauterine infection, of which 5-18% have clinical manifestations from the first hours of life. In 25-30% of cases of congenital infection with cytomegalovirus, a fatal outcome occurs. 80% of those who survive have significant neurological impairment. However, most of the babies infected with cytomegalovirus in the womb do not have pronounced clinical symptoms diseases at birth, but unfortunately, in 10-15% of them, the consequences will appear later in the form of a violation auditory functions, visual impairment to complete blindness, intellectual retardation, convulsions.

Cytomegalovirus in children: causes and routes of infection

The virus can hide for a long time human body without showing himself. But in a situation where the immune system fails, the cytomegalovirus wakes up and causes the disease.

In adults, the virus is transmitted sexually, and children become infected with it while still in the womb or during the passage of the birth canal. But you can get infected later: the transmission occurs in domestic conditions with blood or saliva.

According to WHO statistics, about 2.5% of newborns in Europe become infected with cytomegalovirus. In Russia, the figures are higher - about 4% of children born with symptoms of the disease. Children born from mothers who suffer from cytomegalovirus infection for the first time and in an acute form are immediately prescribed an analysis for antibodies to CMVI. Intrauterine infection with cytomegalovirus is detected according to statistics in 0.4-2.3% of born children.

Signs and diagnosis of cytomegalovirus in an infant

In most newborns with congenital cytomegalovirus infection, signs of positive cytomegalovirus are not visible externally. They have temporary signs of the disease, which, after a certain time, will leave without a trace. Only a few people have the symptoms of congenital CMVI persist for life.

Diagnosis of cytomegalovirus in baby difficult, therefore, if infection is suspected, a blood test for antibodies is taken to detect antibodies to CMVI.

The diagnosis is established by an infectious disease specialist or therapist, guided by the results of special studies. For example, the polymerase chain reaction. You can check blood, saliva, samples from the vagina and cervix, amniotic fluid (during pregnancy). Another method of research for the presence of cytomegalovirus is immune, according to the reaction of the child's immune system. Testing for cytomegalovirus infection is recommended for women planning to become pregnant.

Sometimes a positive cytomegalovirus has signs that are noticeable immediately in the process of birth, although more often the consequences are detected months or even years later. Usually this is a complete loss of vision and hearing.

Temporary signs of the disease include: damage to the liver, spleen of the lungs, yellowing of the mucous membranes of the eyes and skin, purple-cyanotic spots on the skin, reduced weight.

Constant signs of CMVI in newborns are: blindness, deafness, small head, mental retardation, impaired coordination, death.

CMVI should be distinguished from type 6 herpes. Despite the similarity of the clinical manifestations of these two varieties of herpesviruses, type 6 herpes has serious differences. It is important not to miss the following warning signs:

An increase in temperature to 39-40 C, which does not steadily decrease for three to five days.
There are no signs of SARS or intestinal infection.
Roseola on the body appear red rashes.
Convulsions at high temperature.
SARS on the tonsils - herpetic sore throat.
Inflammation such as stomatitis in the oral cavity.
neurological disorders.

If the manifestations of the herpes virus type 6 are not noticed in a timely manner, then the child risks getting severe lesions in the spinal cord or brain. In infants, complications from type 6 herpes lead to death. It is urgent to call a doctor to start on time the child needs medical help.

Diagnosis of cytomegalovirus infection in children

Whether an infection is present in a child will only be shown by a laboratory blood test for the presence of antibodies to CMVI. If the analysis showed a congenital cytomegalovirus, then an acute form of the disease is not necessarily expected and the child is guaranteed to be in danger. Cytomegalovirus IgG positive, what does it mean? If antibodies to cytomegalovirus in the form of lgG are found in a child in the first three months of life, most likely they passed to the baby from the mother carrying the virus and will soon disappear by themselves. In an adult and an older child, this may indicate the development of strong immunity to infection. But if positive antibodies of the lgM class, giant cells that the body produces in order to respond to the invasion of the virus as quickly as possible, are found in the baby’s blood, there is an acute form of the disease with cytomegalovirus.

How to treat cytomegalovirus infection in children

It is completely impossible to cure cytomegalovirus. However, the symptoms can be relieved by using antiviral drugs. medications: Panavir, Acyclovir, Cytotect, etc. Thanks to these drugs, the virus will be under control.

Ill expectant and nursing mothers and children are boosted by immunity and prescribed specialized antiviral drugs. In this case, the main focus is on improving immunity. What are immunostimulant medicinal plants (such as echinacea, leuzea, ginseng and others), dietary supplements (for example, Immunal), immunostimulant medicinal plants (such as echinacea, leuzea, ginseng and others), balanced nutrition (minerals and trace elements), necessarily including fresh vegetables and fruits (vitamins), frequent walks on fresh air and regular exercise stress. To prevent infection of children with cytomegalovirus, it is necessary to provide them with proper nutrition, engage in physical education with them, avoid contact with the sick and observe hygiene.

Treatment of cytomegalovirus in children with folk methods

IN folk recipes there is no specific treatment aimed at eliminating cytomegalovirus infection, but there are many means to improve the state of the immune system. Here are some recommendations:

A mixture of licorice root, alder cones, kopek root, leuzea root, chamomile flowers, string grass - in equal proportions. Prepare two tablespoons of a mixture of chopped herbs pour 0.5 l boiled water and leave in a thermos overnight. Reception: a third or a quarter of a glass, 3-4 times a day.
Garlic and onions help children cope with the virus, especially during the fall and winter cold season. At this time, it is recommended to put a clove of garlic or several onion rings in food every day.
Aromatherapy - spraying oil in the apartment tea tree creates a favorable microclimate for health.
Aspen and alder bark, as well as dandelion root, take one to one. Pour a tablespoon of the collection with 0.6 liters of boiling water and simmer for five minutes over low heat. Reception: 2 tablespoons twice a day before meals.

After entering the body, it begins to actively multiply and settles in nerve cells.

The manifestation of symptoms occurs only during a period of weakened immunity, while in healthy children the presence of CMV in the body is not dangerous.

Ways of infection

The specificity of CMV is that it is found in almost all body fluids (blood, urine, saliva, sputum, sweat, vaginal mucus, semen), so it is very easy for a small unprotected organism to become infected. Ways of transmission of herpes type 5:

antenatal - transplacental from mother to fetus;
intranatal - from mother to child during passage through the birth canal;
postnatal - by airborne droplets or by contact, with blood transfusion, through the mother's breast milk.

Transplacental infection is considered the most dangerous, since the virus penetrates into the amniotic fluid and affects almost all organs and systems of the fetal body.

Symptoms when infected

fever, chills;
runny nose;
cough;
enlarged lymph nodes;
muscle and headache;
fast fatiguability;
enlargement of the palatine and pharyngeal tonsils.

Such symptoms can last from 2 weeks to several months and do not require hospitalization and specific treatment.

Features of the course in children of different age groups

The most severe course of cytomegalovirus infection in children is observed in the congenital form of the disease. The immune system in newborns is very weak, so the virus can easily infect the baby's body and cause disorders and defects that will remain for life.

In the postpartum period, infection most often occurs from parents and is asymptomatic. Most become carriers of CMV between the ages of 2 and 6 years, when they begin to have more contact with other children and go to preschool institutions. The course of the disease during this period is more reminiscent of ARVI, and only if symptoms persist for a long time, a suspicion of type 5 herpes may arise.

After 6-7 years, the immune system finally stabilizes and can actively resist various infections. Primary infection during this period is often asymptomatic, after which the virus remains in the body in a "sleeping" form.

Why is CMV dangerous for children

For healthy child with strong immunity, type 5 herpes is not dangerous, the virus simply lives in the body and does not interfere with its carrier. CMV is dangerous for children with a congenital form of the infection, a weakened immune system or immunodeficiency.

Complications

Children with an asymptomatic course of congenital infection and active CMV in the blood are most susceptible to the development of complications. A few months after birth, they may experience the following complications:

convulsions;
violation of motor activity;
insufficient body weight;
damage to the heart and liver;
micro or hydrocephalus.

If the virus has penetrated the vital systems of the body, then in the first 10 years of life, serious disorders may occur:

mental retardation;
partial or complete deafness and blindness;
violation of the formation of teeth;
speech disorder;
hepatitis;
neuromuscular disorders;
underdevelopment of cardio-vascular system.

The acquired form of the infection does not give similar complications in children with strong immunity. If the body is weakened, then the virus can affect the lungs, liver, heart and kidneys, and the disease itself acquires a chronic relapsing character.

The well-known doctor Komarovsky considers CMV not dangerous for children, except for cases of congenital infection, which can cause. carried out and, but the main method of combating type 5 herpes is to maintain the normal immunity of a pregnant woman.

Under normal conditions, the expectant mother's immune system is able to produce enough antibodies that will protect both her and the baby.

Diagnostic measures

Diagnosis cannot be based solely on the clinical picture of the disease, since in many cases the infection is asymptomatic

General clinical examination methods

CMV screening begins with an examination by a doctor who will differential diagnosis with similar diseases (rubella, pneumonia, etc.) and will prescribe the following laboratory tests:

general ;
general urine analysis;
cytoscopy of urine or saliva;
virological culture from a urine or throat sample.

General analyzes of urine and blood will show the intensity of the inflammatory process in the body, cytoscopy - the presence of cells of a characteristic giant size in the samples under study, and the inoculation of a culture of viruses will tell about their activity.

Serological examination methods

To clarify the diagnosis, determine the infection and the degree of CMV activity, serological studies are carried out. These include:

ELISA ()- detection of protective antibodies Ig G and Ig M in the blood serum. The presence of both immunoglobulins indicates the presence of immunity to the virus, the presence of Ig M - about the primary infection, and Ig G - about the virus carrier. If at re-analysis the amount of Ig G is increased, this indicates the activation of herpes. The absence of protective antibodies indicates that CMV is not detected in the blood.
PCR (polymerase chain reaction) – examination of various biomaterials of the patient (blood, urine, saliva) for the presence of herpes type 5 DNA. Allows you to determine the level of reproduction of the virus in the body.

Allows you to detect CMV even with an asymptomatic infection, therefore it plays important role in diagnostics congenital form diseases.

Treatment Methods

Like all CMV, there is no cure. That's why everything therapeutic actions aimed at reducing the activity of the virus, increasing the body's immune defense and eliminating concomitant diseases. Specific treatment of type 5 herpes is carried out strictly under supervision in the congenital form of the disease and severe course acquired infection.

Antiviral specific treatment

In children, antiviral drugs (Ganciclovir, Cytoven,) and are used to combat. The main focus is on increasing the activity of the immune system, since many antiviral drugs are very toxic to child's body.

Syndromic treatment

If the child has serious disorders of the lungs, liver, heart, or other systems, prescribe additional treatment which aims to eliminate pathologies. To alleviate the manifestations of the acquired form, symptomatic treatment can be prescribed to reduce the symptoms of intoxication: antipyretics, vasoconstrictor drops from a cold, plentiful drink and cough syrups.

Prevention methods

The main way to prevent the congenital form of cytomegalovirus infection is to plan conception and maintain immunity in pregnant women. The expectant mother should take care of her health, undergo routine examinations, avoid close contact with unfamiliar people and carefully observe the rules of personal hygiene.

Prevention of the acquired form of herpes should be carried out by parents from the moment the child is born. Complete care, constant strengthening of immunity and hardening of the child's body - The best way effective control of CMV.

The disease caused by the Herpesviridae virus is similar to the virus herpes simplex. Reproducing in a cell, the cytomegalovirus virus in children leads to the formation of huge cells by increasing the nucleus and cytoplasm. This is a disease with polymorphic symptoms.

In general, CMV infection in children is tolerated without obvious signs. Viruses are resistant to antibiotics. Transmission occurs mainly by contact, less often by airborne droplets. Placental and parenteral (through the blood) routes of transmission are possible. The fetus and newborns are especially susceptible to the disease. Newborns can become infected through breastfeeding from their mother. The CMV virus in children is found 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 can be born with severe signs of the disease. Most often proceeds 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 is not dangerous. With a latent course of the disease, the child will develop immunity, and the body 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, overwork.

Sometimes exposure to an infection can cause serious complications. If the immune system is weakened and a cytomegalovirus is found in a child, this is a signal to start 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 affected and the infection is generalized. If infection occurs in the first months of fetal development, malformations are possible. A child may have hydrocephalus, microcephaly, a violation of the structure of the substance of the brain. On the part of the cardiovascular system, there may be non-closure of the septa of the heart, fibroelastosis of the endocardium, and heart defects. Sometimes malformations of the kidneys, genitals and gastrointestinal tract can occur.

If infection occurs in later dates, cytomegalovirus in newborns shows symptoms after birth. The child develops jaundice, detects damage to the lungs and gastrointestinal tract, hepatolianeal syndrome. Sometimes the disease can be manifested by hemorrhagic rashes. With CMV in newborns, lethargy, frequent regurgitation and diarrhea. Because of this, children gain weight poorly, they have reduced tissue turgor, and fever.

During the first two days, jaundice may appear. 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, the liver protrudes 37 cm from under the costal arch. Hemorrhagic syndrome may present with petechiae and vomiting. In children, hypotension, hyporeflexia are determined. In severe cases, intoxication develops, leading to death.

Cytomegalovirus infection in an infant may be congenital or acquired. The disease in the congenital form is much more difficult, since the virus has time to cause significant harm to the child's body even 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 in infants does not manifest itself.

The nature of the development of the disease depends on the maturity of the fetus during intrauterine infection, the immunity of the mother and the immune reactivity of the child. 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 old can manifest itself as a lesion only of the salivary glands. In response to the introduction of the virus into the cells, a pronounced dysfunction of the affected organ may occur. In severe cases, cytomegalovirus in an infant can cause adrenal insufficiency, and with immunosuppression, damage to all organs.

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

Cytomegalovirus in a child at 2 years old can lead either to an isolated lesion of the salivary glands, or to damage to organs. However, unlike the congenital form, the disease is more often manifested by mononucleosis. The child may experience a gradual increase in temperature, sore throat, swollen lymph nodes, hepatosplenomegaly, swelling of the throat mucosa, and abdominal pain.

The immune system of children under 5 years of age is not yet able to provide 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, persistent cough, cyanosis. It is possible to attach violations of the functions of the gastrointestinal tract and liver. The temperature can reach 40 degrees. This condition can last from 2 to 4 weeks.

With a 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 the cardiovascular system, parenchymal hepatitis and encephalitis. With complications of CMV in children at the age of five, they are treated, including the appointment of immunoglobulins (Interferon) in the complex of measures. After five years, the child's body is able to cope with the infection itself without serious consequences.

What are the symptoms and signs of infection in children?

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

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 antiviral drugs, which translate the disease into a passive form.

In case of reduced immunity CMV symptoms in children, they can manifest themselves depending on the lesion of the organ or on the form of the disease. The virus infects 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 CMV infection children are polymorphic. The generalized form is severe and can be fatal in the first 2 weeks of life. With isolated forms of damage to any organ, it can be asymptomatic.

When is treatment needed?

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

More often CMV treatment in children, it is carried out with the appointment of human immunoglobulin (Megalotekt, Cytotekt). These drugs are non-toxic and can be used in the treatment of children of any age. IN exceptional cases for the treatment of newborns, more toxic antiviral drugs are prescribed - Ganciclovir, Cidofovir. Such therapy is carried out in cases of severe lesions of the visceral organs. However, before treating cytomegalovirus in a child toxic drugs, the degree of complications caused by the virus should be assessed. The therapy itself and the set of drugs that are used for treatment should correspond to the immune status of the child.

The virus carrier itself or a disease that occurs in a mild form (mononucleosis syndrome) in children with normal immunity does not require therapy. It is enough to use vitamins and fortifying drugs in order to strengthen immunity. During periods when outbreaks of infectious diseases occur (influenza or acute respiratory infections), the use multivitamin complexes protect the child from the virus.

Why is cytomegalovirus dangerous in a child?

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

Scientific studies have established the risk of infection of the fetus in the first half of pregnancy. Having entered the body, the virus exhibits a teratogenic effect. As a result, there is a violation of the development of the brain, organs of hearing and vision, visceral organs.

Analysis for cytomegalovirus in a child

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

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

The most informative analysis for CMV in a child is the PCR method. Not only CMV DNA can be detected PCR method in children, but also the activity of the virus. However, this method is one of the most expensive. They also use another method that allows you to establish antibodies to cytomegalovirus in a child - serological (ELISA). The analysis determines several types of antibodies and the stage of the disease.

Some differences in antibodies should be understood. Class M immunoglobulins are produced in response to a virus. They cannot form immunological memory, therefore, with their disappearance, protection against the virus disappears. Immunoglobulins G are produced after the suppression of infection throughout life, developing a stable immunity to the disease.

If anti-CMV IgG is detected in a child, but anti-CMV IgM is not detected, this indicates that lifelong immunity to the virus has developed in the body. That is, this is the CMV norm in children, which does not require treatment. If cytomegalovirus in children igg positive, but anti-cmv IgG antibodies were not detected, the analysis shows that there is no stable immunity to the virus in the body. Antibodies suppress the development of the virus and help to carry the disease without symptoms. If the child does not have antibodies to cytomegalovirus (cmv g), this is due to the absence of the disease or a 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. Usually, this increases the concentration of igM antibodies.

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

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

Mostly, cytomegalovirus in children is detected by chance, when antibodies to CMVI (Cytomegalovirus infection) are present during a blood test. Almost 60% of children are infected with CMVI, but the virus is in a latent phase (in sleep mode) until a certain time, namely, until the immune system decreases, without showing itself. Below we will talk about the causes and treatment of this disease, as well as how cytomegalovirus infection manifests itself in children.

Common Causes

Initially, the pathogen enters the respiratory system, digestive system or genital organs through the mucous membranes of the mouth and nose. In the field of CMVI introduction in children, modifications (changes) usually do not occur. The virus, once in the body, continues to exist there forever, being in a latent phase until the immunity of the child's body decreases.

Causes of immune deficiency can be:

chemotherapy;
frequent colds- ARI, ARVI, tonsillitis;
the use of cytostatics (drugs that suppress cell division);
HIV AIDS;
severe illnesses.

The source of infection with cytomegalovirus in children is only the virus carrier - a person with CMVI. Consider several options for transmission of infection:

transplacental - the infection is transmitted to the fetus by the penetration of the virus through the placenta from an infected mother;
contact route of transmission of infection - when kissing with the help of saliva, it enters the mucous membranes of the mouth and throat, through the larynx into the upper respiratory system;
airborne transmission line - when the virus carrier sneezes or coughs while communicating with him, as well as with the help of saliva;
household way of transmission of infection - with the general use of household items.

Cytomegalovirus infection in a child, as a rule, most often occurs at the age of two years. Children already go to kindergarten or to school, but personal hygiene is not yet treated more scrupulously. In addition, they like to exchange different items or share food and different goodies.

Ways of infection of the fetus in utero or a newborn baby

A newborn baby can be infected by a sick mother during childbirth (intranatal) or breastfeeding (50% of cases of infection). Cytomegalovirus in a child can occur when the mother has an acute or exacerbated cytomegalovirus disease. In this case, infection of the fetus leads to the development of congenital cytomegaly in children.

A particularly serious danger is when a viral infection of the fetus occurs at the beginning of pregnancy, approximately in the first three months. This can lead to the death of the child, and cytomegalovirus infection in newborns can be reflected in the occurrence of defects of a different plan - deformity or pathology internal organs.

Classification of cytomegalovirus in children

CMVI is characterized by a numerous variety of forms:

latent (sleep mode) or acute;
localized (place of formation of the pathological process);
generalized (spread of an abnormal process throughout the body or separate body from the site of infection)
acquired;
congenital.

As a rule, CMVI in newborns occurs in utero. Most often this happens when a woman becomes infected with this disease before conceiving a child or during pregnancy. The fetus becomes infected through the placenta. If infection occurs at an early stage of pregnancy, then most often the pregnancy ends in miscarriage.

Symptoms

Signs of congenital cytomegalovirus

With neonatal (newborn period) infection, malformations can become symptoms of cytomegalovirus in children further development. The virus assists in the formation of heart disease, a pathological deviation in the formation of the brain and other severe abnormal processes in the child's body.

The first symptoms of the actual presence of cytomegalovirus infection in children are the following signs:

hypotonicity (reduced tone) of muscles;
general weakness;
lethargy;
restless sleep;
inability to digest food;
reduced appetite.

In rather severe cases, death is likely, possibly in the first weeks after birth.

When infected in the third trimester, in children, as a rule, congenital malformations are completely absent. But there may be complications that are expressed by jaundice (liver disease and biliary tract), hemolytic anemia(blood disease), hydrocephalus (dropsy of the brain) and other serious pathologies.

Signs of Acquired Cytomegalovirus

Acquired cytomegalovirus can manifest itself in extremely rare cases. Basically, it is in a latent phase, showing no effect on the baby's body, which indicates high work child's immunity. This means that the immune system prevents the reproductive activation of this virus.

If children have low immune defense, then the disease will be expressed by frequent colds. These can be acute respiratory viral infections, acute respiratory infections with high body temperature and inflammation of the lymph nodes.

In chronic immune deficiency, the body of children is often exposed to infection. In current situation possible complications localized (located) in some systems of the child's body:

nervous system;
digestive system;
the cardiovascular system;
urinary system.

The form of this virus is treated for a long time, most often unsuccessfully. But CMVI of a complicated type is very rare. Signs of the disease and methods of treatment - vital necessary information. Parents who care physical health their children, will necessarily seek to prevent permissible Negative consequences cytomegalovirus.

Diagnostics

Correctly diagnosing cytomegalovirus infection in children is very difficult, because the manifestations visually resemble some colds. The attending physician carefully examines the children, if necessary, gives directions for testing for research.

Analyzes

To detect cytomegalovirus in children, it is necessary to pass tests:

blood for the presence of immunoglobulins of class M and G to cytomegalovirus. Detection in the blood of class M immunoglobulins to CMV indicates primary infection, and if immunoglobulins G are detected, it indicates a chronic course of the disease;
using PCR of urine and saliva, you can consider the presence of the pathogen itself;
with a general blood test in children, the number of erythrocytes, platelets, and also leukocytes is examined;
biochemical blood tests to examine liver enzymes.

Methods of instrumental research

This examination is appropriate for:

ultrasound abdominal cavity for the study of the liver and spleen;
MRI or ultrasound of the brain to study foci of inflammation.

With generalized infectious disease children are referred to an ophthalmologist for an examination of the fundus.

Treatment

Treatment of cytomegalovirus infection in children greatly depends on the age of the baby, the form of the disease and its severity. The dormant form (latent form) of the virus does not require special treatment. In this case, children need more Special attention in terms of full provision of the following aspects:

balanced diet;
daily walks in the fresh air;
easy hardening of the child's body;
increased psychological comfort.

Probiotics (apathogenic bacteria for humans, ensure the restoration of microflora) and vitamin complexes help prevent dysbacteriosis and maximize digestion improvement.

Treatment of cytomegalovirus is required only for children with acute CMV. The mononucleosis-like form of the disease does not require special treatment, but symptomatic treatment is actively used.

With intrauterine cytomegalovirus, as well as with severe obvious (manifest) forms, a stationary complex treatment and turns on antiviral treatment as:

antiviral drugs (Ganciclovir, Foscarnet);
anticytomegalovirus Immunoglobulin (Cytotect);
interferons (Viferon).

Antiviral drugs have a pronounced toxic side effect on the circulatory system, as well as on the kidneys and liver. In this case, these drugs are prescribed to children in case of a significant excess of their therapeutic effect over a high risk of developing side effects. Some decrease in toxicity is often recorded with the combined use of antiviral drugs with interferon.

Unfortunately, antiviral medicines do not rid children of the virus, do not lead to the most final healing. But their practical use in a timely manner will prevent the formation of complications and literally transfer the virus into a latent mode and a completely inactive form.

In order not to harm the health of the baby, you need a mandatory consultation with a pediatrician to find out how to treat cytomegalovirus and how. If necessary, the attending physician will give directions for examinations to such specialized specialists as:

infectious disease physician;
neurologist;
nephrologist;
urologist;
ophthalmologist (oculist);
hepatologist;
gastroenterologist;
dentist;
pulmonologist;
immunologist.

Summing up, it is worth recalling that cytomegalovirus infection, with certain forms of flow, does not always need treatment. It should also be noted that self-medication with CMVI is not allowed, especially for newborns. Therefore, at the first suspicion of an infection, immediately contact pediatrics.

Almost all age categories people are at risk of contracting cytomegalovirus infection.

Cytomegalovirus in children can lead to severe complications, especially when it comes to babies. But the older the child becomes, the less dangerous it is for him to encounter the virus.

Cytomegalovirus is a type of herpes. What they are absolutely similar in is that they “occupy” a person forever. Once in the body, pathogens remain there for all the remaining years. As long as they “doze”, this does not affect health in any way.

Many people, having from birth or from early childhood such a “delayed-action mine” inside themselves, do not know what the consequences of this virus are.

And all thanks healthy lifestyle life and strong immunity.

Ways of infection

Cytomegalovirus infection spreads by contact, through all secretions (saliva, urine, cough sputum, mother's milk and seminal fluid).

It is also transmitted through the blood, so even an unborn child can become infected from its own mother.

In total, there are three most common types of infection in the youngest children:

Intrauterine.
During the passage of the birth canal.
Through mother's milk while feeding.

The first of them, when the infection penetrates into the child's body that has not yet formed and does not have any protective barrier through the placenta, is fraught with the most serious consequences.

A child who has a congenital cytomegalovirus infection may have multiple developmental abnormalities, including:

reduced vision and hearing;
physical underdevelopment;
neurological problems.

Therefore, the state future mother doctors give the most close attention. A pregnant woman should take all measures not to get infected.

Nursing mothers should be just as careful.

Grown up kids attending nurseries and kindergartens can also catch this virus, but at their age it is not so dangerous.

Healthy pregnancy - healthy baby

It is no coincidence that pregnant women are required to be tested for cytomegalovirus, since an infection from the mother's body can easily be transmitted to a newborn baby.

The most dangerous thing is if a woman becomes infected for the first time during pregnancy. Then her immunity simply cannot cope with the virus, and the disease can manifest itself in an acute form, endangering the life of the mother and the unborn baby.

It should be remembered that CMV infection during pregnancy can also occur sexually. Therefore, it is better to take precautions: use condoms.

If pregnancy is only planned, a woman must be screened in advance for the presence of antibodies of the virus, indicating that she has already had this infection.

If the result is negative, it is necessary at all costs to prevent accidental infection during this crucial period.

Different ages, different symptoms

Depending on how old (or months, days) the sick child is, the symptoms of cytomegalovirus infection manifest themselves in different form.

In newborns, after intrauterine infection, these signs may be:

jaundice;
rash;
convulsions;
enlarged liver and spleen.

In infants who acquire the virus through mother's milk, the development of infection may be associated with pneumonia and hepatitis.

And in older children, the virus may not manifest itself in any way, or it can do it indirectly, in the form of:

rapid fatigue;
feeling of ache in the joints;
headache;
body temperature above normal.

These symptoms can be seen as in full force”, and only its individual points.

In immunocompromised children, the signs of infection will be much more pronounced than in their more healthy peers.

If for a strong child's body an infection transferred in a mild form is even "useful" in some way (after it the child acquires stable protection against CMV for all subsequent years), then in weak children the disease can cause severe complications.

Asymptomatic course

deformity of the skull due to the influence of cytomegalovirus

When schoolchildren or preschoolers do not have clear signs cytomegalovirus infection, even in the presence of an active virus, is an indicator of good body resistance.

But with babies, things are different. Latent infection, which for several months no one suspected, one day suddenly “splashes” out. CMVI in children of such a tender age can manifest itself in the form severe convulsions, weight loss, skull deformities and movement disorders.

In a few years, these guys may be diagnosed with signs mental retardation, visual disturbances, or heart problems.

The causes of severe pathologies are that cytomegalovirus infection in newborns was not cured in a timely manner.

How the disease progresses in the smallest

Cytomegalovirus in children does not make itself felt immediately after it enters the body. It can "get used to" for weeks and only then begin its malicious activity.

In an infant, this infection will primarily affect the liver. The icteric manifestations on the face of an infant can last up to six months, and he himself will be extremely restless, with poor appetite and low weight gain.

If the virus affects the blood, it will show up in bruises and rashes on the skin, and there may be blood particles in the stool and urine. And when the amount of urine excreted decreases sharply, an “attack” on the kidneys began.

Convulsions, blurred eyes, dropsy of the head - all these are manifestations of CMV in newborns. Due to the fact that the development of infection at this age is very difficult and can lead to grave consequences, you should immediately consult a doctor at the first disturbing symptoms.

The consequences of cytomegalovirus, not cured in a newborn, can lead to disability or even death of the child.

Not to be confused with a cold!

The child has - coughing, stuffy nose and fever? Most parents, without hesitation, will put "their diagnosis": an acute respiratory viral infection. Although in fact, cytomegalovirus can act here.

In addition to the symptoms listed above, it causes:

enlarged lymph nodes;
white coating in the mouth and inflamed tonsils;
chills and sometimes rash;
muscle pain;
general weakness.

Since the infection in children over the age of one is already clearly acquired, and not congenital, it does not threaten anything especially terrible.

According to the degree of intensity, the disease can occur in several forms.

Namely:

Mild, in which the child can recover, even without treatment.
Medium. The virus "affects" the internal organs, but these lesions are reversible.
Severe, with serious violations of the functioning of internal organs. With an acquired infection, this form is quite rare.

With timely proper treatment It will be possible to say goodbye to the disease in a couple of weeks. Only in exceptional cases, some of its manifestations (inflammation of the lymph nodes, tonsils) may linger for 2-3 months, and then it will be necessary to apply again for medical assistance.

"Identify" the virus

There are several laboratory methods for the diagnosis of cytomegalovirus infection.

Such as:

Blood test for antibodies to CMV.
General analysis blood (with the development of the disease, it will indicate lower rates erythrocytes, leukocytes and platelets).
Analysis of urine and saliva for virus cells.
A biochemical blood test that examines immunoenzymes and determines the concentration of urea and creatinine.

In the presence of cytomegalovirus in the urine of a child taken for analysis, a sediment of a peculiar type is formed - cells with the so-called "owl's eye".

The sick child may also be referred for a chest X-ray, ultrasonography of the head or abdominal cavity, based on which zone the virus has chosen as the “territory of the lesion”. You may also need to consult an ophthalmologist.

How is the treatment

How long and difficult the treatment of cytomegalovirus infection in children will be depends on the severity of the disease. Scientists have not yet created a drug that “cracks down” on CMV, and known antiviral drugs in the fight against it are not particularly effective. The emphasis in therapy is on strengthening the body's defenses of the child himself.

Treatment is carried out by infectious disease specialists and pediatricians. But if necessary, specialists in neurology, ophthalmology, urology and others come to their aid.

To cure cytomegalovirus in a newborn with a congenital or complicated form of infection, immunoglobulin preparations are used, which are harmless to children of any age. Antivirals, active against herpes, are used only in the most severe cases.

The disease is acquired, occurring without symptoms in the smallest, does not require treatment.

For children over three years old with mild form diseases take only the most simple means- to lower the temperature or narrow the vessels in the nose, provide peace and fairly frequent drinking. Otherwise, they give the body the opportunity to cope with the virus itself.

In more serious cases prescribe a special treatment for the onset of inflammatory processes or lesions of certain organs.

When immunity is deficient

Cytomegalovirus infection in children with severely reduced immunity is truly dangerous. If left untreated, it can cause complications that result in death or permanent disability.

By the way, according to the statistics of the World Health Association, the mortality rate from CMV ranks second in the world among all viral diseases.

With especially serious lesions, children with immunodeficiency affected by this infection are even transplanted internal organs and bone marrow. Each such case is considered separately and requires specific, individual therapy.

With any form of manifestation of cytomegaly, it should be remembered that it is possible to treat diseases of such a plan only under the supervision of a doctor, to use drugs strictly for their intended purpose. Using the advice of "knowledgeable" friends and acquaintances is simply unacceptable.

medicinal herbs against the virus

Is it possible to cure a child's cytomegalovirus infection with drugs traditional medicine? Partly, yes. It will not be possible to completely destroy the virus in the child's body with their help, but to strengthen it defensive forces for effective independent struggle healing herbs will help.

Here are some recipes medical fees:

Combine flax seed with crushed raspberry leaves, marshmallow and cinquefoil roots, taken in equal parts, and half of elecampane roots. Pour boiling water over the mixture (half a liter of water per two tablespoons of the collection) and, placing it in an airtight container, leave overnight in a warm place.
Chopped herbs (chamomile, string, as well as alder cones, licorice root, kopeechnik and leuzea), taken in equal proportions, pour 500 ml of boiled water (two tablespoons of the mixture). Leave for 10 hours.

Medicinal infusions for children school age you can give 1/6 cup three times a day. But before starting such treatment, be sure to consult your doctor so that there is no side effects.

Preventive measures

Cytomegalovirus in a child in the body is not yet a disease. Most of us have this "intruder" inside us. The main thing is not to let him become active and start his malicious activities. Such a deterrent function is performed by human immunity, and the stronger it is, the more reliably we and our children are protected from infection.

What can be done to strengthen the defenses of the child's body? Doctors advise to observe such measures:

Make sure your child sticks to correct mode day, slept well and spent more time outdoors.
The diet should be balanced and rich in vegetables and fruits.
Offer children herbal teas, give them multivitamins.
Since CMV is spread by contact, teach your child to wash their hands thoroughly after returning from the street and after each visit to a public place.

If the child constantly has a cold, consult a doctor. Perhaps it is worth doing an analysis for cytomegalovirus, to make sure that this is not the reason.