Treatment of cytomegalovirus infection in children. Cytomegaly, cytomegalovirus infection in a child

Cytomegalovirus in children (CMV) is an infectious disease caused by a specific microorganism Human betaherpesvirus 5. In most cases, the pathogen is detected in the study of blood and urine using the polymerase chain reaction method. In many children, cytomegalovirus infection does not manifest itself as severe symptoms, and only when exposed to a number of factors do the first signs develop.

What is cytomegalovirus in children

Cytomegalovirus in a child is able to penetrate into the tissues of all organs, but it is most active in the salivary glands, multiplying rapidly and embedding its DNA into the cell nuclei. When an infectious agent is introduced, lymphocytes and monocytes are affected. The disease leads to an increase in the cells of the salivary glands, which was the reason for the name of the virus (translated from Latin - "giant cells").

The infection damages not only the blood vessels, but also the tissues of the internal organs of the child, disrupting their blood supply and leading to hemorrhages. The virus causes a significant change in the shape and structure of leukocytes and phagocytes, resulting in the development of signs of immunodeficiency. In a healthy state of the protective forces of the child's body, the virus is not active.

With a decrease in immunity, the disease begins to manifest itself with various symptoms.

What is dangerous for the child

The congenital form of cytomegalovirus infection can cause mental retardation in a child. The chance of death in infants is 30%. The disease leads to visual impairment and blindness. In 18% of cases, damage to the nervous system occurs. Children develop convulsive symptoms, high anxiety, weight loss, skin reactions.

Ways of infection and causes of CMV in a child

Infection of young children often occurs during contact with an infected mother. The virus can be transmitted not only with milk and saliva, but also with sweat, blood and other body fluids. The main routes of infection are:

1. Airborne. The infection can enter the body of a healthy baby if there is a sick person nearby.
2. Transplacental. The virus is transmitted from the mother during childbearing.
3. Contact. Infection occurs when biological materials come into contact with the baby's skin.
4. parenteral. The likelihood of infection with cytomegalovirus increases during a blood transfusion or the use of untreated medical instruments.

Types and forms of children's cytomegalovirus

There are two main types of CMV:

• congenital;
• acquired.

Often, infection occurs during childbearing. The virus crosses the placenta and enters the amniotic fluid, when swallowed, it invades the cells of the developing child's body.

Doctors consider the first two weeks after conception to be the most dangerous period.

In this case, the risk of developing irreversible changes in the fetus is extremely high. The infection can cause miscarriage in early pregnancy. Cytomegalovirus is considered acquired if it is transmitted from the mother. The risk of infection increases with kissing, skin contact.

Depending on the location of the focus, the following forms of cytomegalovirus infection are distinguished:

1. Localized. Formation takes place in one place.
2. Generalized. The abnormal process spreads throughout the body.

Also, the disease is classified according to its course into:

• latent:
• acute.

Symptoms and signs

Signs of congenital cytomegalovirus infection are malformations of the child's body. The disease causes disorders of the heart, brain activity and other abnormal processes. Doctors may suspect the presence of a congenital form of CMV with muscle hypotension, general weakness of the body, lethargy, inability to digest food. In such babies, sleep disturbance occurs, there is no appetite and body weight does not increase. With severe damage to the child's body, there is a risk of death in the first month after birth.

If the fetus was infected in the third trimester, there are no signs of congenital malformations. Complications can be diseases of the liver, blood. In some infants, the disease is accompanied by signs of hydrocephalus, an enlarged spleen, and hyperthermia. In addition to inflammation of the lymph nodes, babies develop skin rashes that can bleed.

The acquired form of cytomegalovirus infection rarely manifests itself with certain symptoms. Often it is latent and does not affect the child. This phenomenon is observed under the condition of the normal functioning of the baby's immune system. With a reduced resistance of the body, an infectious process begins to develop, which has signs resembling acute respiratory infections. The child has a chest cough, sputum is released, body temperature rises, urination becomes more frequent. The disease is accompanied by inflammation of the respiratory tract, nasal congestion, pain when swallowing. In some cases, a reddish rash appears on the skin.

When the pathogen is activated in the body, the cervical lymph nodes begin to increase in the child. Usually they do not bother the baby. Enlargement of the liver, spleen is accompanied by the appearance of discomfort in the abdomen. In this case, engorgement of the inguinal and axillary lymph nodes is observed. A sign of liver damage is yellowing of the skin and eyes. Cytomegalovirus infection can manifest itself as signs of a sore throat: the child complains of pain in the joints, drowsiness, lethargy, and hyperthermia are observed.

If these symptoms occur, you should immediately consult a doctor.

Blood test for cytomegalovirus in a child

In addition to an external examination, if a cytomegalovirus infection is suspected, a child is prescribed blood tests. Serum contains immunoglobulins. Class M antibodies appear in the body immediately after the introduction of the virus into the cells of the organs. Protein compounds can be fixed already in the first 14 days from the moment of infection. Immunoglobulins IgM persist for six months. When they are detected, we can talk about the initial form of the disease.

Antibodies of class G are detected one month after the penetration of cytomegalovirus and remain in the blood throughout life. Thus, the immune system can effectively fight the activation of the infection.

Determination of quantitative indicators of antibodies allows you to monitor the dynamics of the disease and prescribe timely treatment. In the severe course of the infectious process, the synthesis of immunoglobulins is markedly reduced. Laboratory methods do not determine the amount of proteins in the blood, but reveal the degree of their activity. Serum is diluted in a ratio of 1 to 100. If the normal level of immunoglobulins is exceeded, we can talk about the occurrence of the disease. Normal IgM< 0,5. Увеличение показателя указывает на положительный анализ.

Blood for antibodies to cytomegalovirus in a newborn is examined without fail if the mother suffered from an acute form of the disease during pregnancy. In this case, the decoding of the analysis often shows the presence of class G immunoglobulins. This indicator does not always indicate that the infant has a congenital form of cytomegalovirus infection. The presence of IgG antibodies in the blood indicates the presence of the disease in the mother. An indicator of the infection of the baby is the excess of the norms of class M immunoglobulins. The urine and saliva of the child can serve as biological material for laboratory research. It is recommended to donate blood on an empty stomach.

Treatment

When prescribing treatment, the doctor should consider the following factors:

1. Type of cytomegalovirus infection. Determined by enzyme immunoassay. With the acquired form of the disease, there are often no symptoms and changes in the organs and systems of the baby. The presence of the virus during the normal functioning of the child's immunity is not dangerous.
2. The nature of the course of the disease. When an infection occurs, the severity of the symptoms is taken into account.
3. The state of the immune system. Not only the course of the disease, but also the speed of recovery depends on the functioning of the body's defenses.

Dr. Komarovsky about cytomegalovirus infection

Pediatrician E. Komarovsky believes that the use of antibacterial agents in the detection of cytomegalovirus infection is not justified, since such drugs are not able to help with this disease.

An antimicrobial drug is prescribed to a child when signs of complications appear, manifested by the development of inflammatory processes in the internal organs.

The antibiotic is selected individually, taking into account the child's body weight and the presence of chronic pathologies. The treatment of the disease is carried out in the same way as the therapy of herpesvirus. Children are prescribed drugs ganciclovir, cytoven. The dosage is calculated taking into account the weight of the child (10 mg / kg), after 21 days it is reduced to 5 mg / kg. Therapy with the use of an antiviral drug is carried out until the signs of the disease disappear and laboratory parameters decrease, which indicate the degree of infection activity. In the congenital form, ganciclovir is used for one and a half months at a dosage of 10 mg / kg. If there are signs of intolerance to the drug, another antiviral agent is selected for the child.

If there is an exacerbation, an antipyretic medication (ibuprofen) is prescribed. During this period, the pediatrician recommends drinking plenty of fluids, multivitamin complexes. Naphthyzine, sanorin are prescribed to normalize nasal breathing. With the appearance of swelling of the mucous membranes, an antihistamine medication is prescribed.

Of great importance in the treatment of CMV is the use of immunostimulating agents. The child is injected with a preparation containing immunoglobulins against cytomegalovirus. Course - 10 injections.

After the symptoms of the disease subside, the child is shown physiotherapy (massage, UHF).

ethnoscience

The basis of most recipes that help to cope with the disease are herbal preparations. When using folk remedies, you need to remember that the child may develop allergic reactions. The appearance of a sign of intolerance to herbs by the baby's body from treatment by non-traditional methods must be abandoned.

With cytomegalovirus, you can use a collection consisting of licorice roots, kopeechnik, leuzea, alder seedlings, succession and chamomile flowers. The dry mixture is thoroughly mixed, 2 tablespoons are taken. plants and pour ½ liter of boiling water. For insisting, it is better to use a thermos. The remedy is given to the child 50 ml four times a day.

For the treatment of CMV, you can use a collection of thyme, birch buds, succession, wild rosemary, leuzea, yarrow, burnet roots. 2 tbsp dry plants are poured with 500 ml of boiling water. After 10 hours, the infusion is filtered and the child is given 50 ml three times a day.

As a means to strengthen the body's defenses, you can use the extract of lemongrass, ginseng, echinacea. The collection of lungwort, violet, nettle and birch leaves, plantain, rose hips, dill seeds helps to speed up recovery. 4 tsp the mixture is poured into 1 liter of boiling water and infused for 9 hours in the dark. The drug is taken three times a day, 40 ml. Children are encouraged to prepare fresh decoctions daily.

For babies up to a year old, when preparing medicinal infusions, you need to use ½ tsp. dry herbs.

Before using traditional medicine for the treatment of cytomegalovirus infection in children, you should consult a pediatrician.

In the early days, it is recommended to give a minimum amount of infusion. Under the condition of normal tolerance, the dosage increases. The course of treatment with infusions is at least one month. The use of folk recipes for the treatment of children is allowed while conducting drug therapy.

Complications and consequences

The greatest danger of cytomegalovirus is for the fetus and children of the first years of life. The causative agent of the disease has the ability to penetrate the protective filters of the placenta. When an infection is introduced into a developing embryo, the risk of developing serious defects is very high.

The baby's own immune system begins to work actively closer to the first year of life. When activated, the infection can threaten to damage the organs of the digestive tract, hemorrhage in their tissue.

With a congenital form of CMV in children, the development of:

• anemia;
• encephalitis;
• neuropathy;
• brain cancer;
• lymphocytosis;
• bacterial sepsis.

With the addition of another type of infection with untimely treatment, a fatal outcome is possible.

To prevent the development of complications, it is important to constantly maintain the immune system of the child.

The main activities are:

1. Balanced diet. Ensuring proper nutrition with plenty of greens, vegetables, cereals, fiber, natural dairy products helps strengthen the body's defenses.
2. Physical exercise. Moderate sports training is essential for boosting immunity. For children, classes in the pool, Pilates, aerobics are useful.
3. Day rest. Preschool children should sleep 1.5-2 hours after lunch. You must first ventilate and, if necessary, humidify the room.
4. Regular walks. Fresh air and movement help restore immunity. Walking with a child is necessary away from the tracks.
5. hygiene measures. It is important to teach a child to wash their hands before eating, after a walk, visiting a kindergarten. It must be remembered that the pathogen can be transmitted by contact.

The disease caused by cytomegalovirus infection can lead to serious consequences. The most dangerous is the congenital form, which often leads to the development of defects and miscarriages. Treatment of the disease is based on stimulating the immune system, fighting the virus and preventing the appearance of a bacterial complication. Prevention is aimed at increasing the body's defenses. All drugs for the treatment and prevention of the development of cytomegalovirus infection are prescribed by a doctor.

Doctor Maria Nikolaeva

Cytomegalovirus infection is one of those infections that a person encounters at an early age. It is caused by a virus from the herpes family, under the influence of which specific changes occur in all tissues and organs. Cytomegalovirus in children is congenital and acquired - the clinical picture of these forms varies significantly.

If antibodies to cytomegalovirus are found in a child’s blood test, this means that he was infected with this infection. Often the disease is asymptomatic, so the moment of infection is difficult to determine.

The causative agent after penetration into the body is introduced into the cells. This causes the development of the inflammatory process and dysfunction of the affected organ. Cytomegalovirus causes general intoxication, disrupts the process of blood clotting, and suppresses the work of the adrenal cortex. The main site of cytomegalovirus localization is the salivary glands. In the blood, the pathogen infects lymphocytes and monocytes.

The nature of the course of the disease depends on several factors:

• age;
• the state of the immune status of the child;
• the presence of comorbidities.

Often cytomegalovirus is fixed in the cells and takes a dormant state without causing any symptoms. Activation of the virus occurs when favorable conditions arise for it - first of all, this is a decrease in the body's resistance. This will determine how to treat cytomegalovirus infection in children.

Some useful facts about CMVI:

• an inactive virus that is in the cells is not amenable to drug treatment, a person remains its carrier forever;
• in older children, cytomegalovirus causes mild acute respiratory infections;
• most dangerous in newborns and children with reduced immunity;
• diagnosis of inactive CMVI is rather complicated;
• low immunity contributes to the generalization of the infectious process.

The detection of CMV in children is not always an indication for emergency treatment. Therapy is prescribed only under the condition of obvious clinical symptoms.

Cytomegalovirus detected - what to do?

Causes of the disease in children

The cause of the disease is infection with a pathogen called cytomegalovirus. It is a member of the herpesvirus family. The virus is widespread throughout the world, easily transmitted between people. Therefore, a person becomes infected with an infection in the first years of life. The most sensitive to cytomegalovirus fetus during fetal development and newborns.

Cytomegalovirus in a child appears upon contact with any biological fluids. The spread of the virus occurs by airborne droplets and contact. You can also become infected through a transfusion of infected blood. In utero, the fetus becomes infected when the virus passes through the placenta, or during childbirth. Infection with cytomegalovirus in children under one year old occurs through breast milk. The causative agent is very stable in the environment. It dies under the influence of high temperatures or freezing, it is sensitive to alcohol.

How does cytomegalovirus manifest itself

The course of cytomegalovirus infection in a child is cyclic - the incubation period, the peak, the recovery period. The infection can be localized and generalized, congenital and acquired. Also, an infectious disease in a child is often asymptomatic. Clinically, cytomegalovirus manifests itself in 30-40% of children.

The incubation period of cytomegalovirus infection is variable - from 15 days to 3 months. During this period, there are no signs of illness, but the baby is already a source of cytomegalovirus infection.

Symptoms of cytomegalovirus

Congenital and acquired CMVI in children - what's the difference?

The difference between congenital and acquired forms of CMVI in children is in the nature of the course. The congenital form of the disease proceeds in a generalized manner. Acquired cytomegalovirus is characterized by damage to one of the body systems, less often it is generalized. CMV is dangerous for the baby most of all in a generalized form.

congenital

Congenital cytomegaly is characterized by intrauterine infection of the fetus. Infection occurs through the placenta in acute or chronic CMVI in the mother. The virus is localized in the salivary glands of the fetus. Here it multiplies, enters the blood and causes a generalized process. Congenital disease manifests itself in 0.3-3% of newborns. The risk of fetal CMV infection from a sick mother is 30-40%.

If the infection occurred in the first trimester of pregnancy, the outcome is fetal death and spontaneous miscarriage. Less commonly, the fetus remains viable, but it develops numerous malformations:

• central nervous system- develops microcephaly (underdevelopment of the brain) or hydrocephalus (accumulation of fluid in the brain tissue);
• the cardiovascular system- various congenital heart defects;
• gastrointestinal tract- underdevelopment of the liver, intestines.

If the infection occurred in the second half of pregnancy, the baby is born without malformations. Symptoms of the disease in this case:

• jaundice - persists for two months;
• enlargement of the liver and spleen;
• pneumonia;
• intestinal inflammation.

A child is born prematurely, with low body weight. There is an inhibition of reflexes, the processes of sucking and swallowing. The condition of the baby with congenital cytomegalovirus infection is severe. There is persistent fever, lack of appetite. The child is lethargic, grows poorly and hardly gains weight. Darkening of urine, light liquid stools are observed. Point hemorrhages appear on the skin.

The acute course of cytomegalovirus disease leads to the death of the baby within a few weeks.

The most common manifestations of congenital CMVI:

• hemorrhagic rash - 76%;
• yellowness of the skin - 67%;
• enlargement of the liver and spleen - 60%;
• underdevelopment of the brain - 52%;
• low body weight - 48%;
• hepatitis - 20%;
• encephalitis - 15%;
• damage to the optic nerve - 12%.

Table. Manifestations of CMVI depending on the period of intrauterine infection.

The most common manifestation of CMVI in children is hepatitis. It occurs in icteric or anicteric forms. The latter is characterized by poor clinical symptoms, the child's condition is satisfactory. In the icteric form, hepatosplenomegaly, moderate staining of the skin, dark urine and light feces are noted.

Rarely, the outcome of hepatitis is the formation of biliary cirrhosis of the liver, from which children die in the second year of life.

Pneumonia ranks second after hepatitis. It is characterized by an increase in body temperature, cough with sputum. Children develop shortness of breath on exertion and at rest. A feature of pneumonia caused by cytomegalovirus is a protracted course.

Retinitis is damage to the optic nerve by cytomegalovirus. It is characterized by decreased vision, flies and color spots before the eyes. The baby has photophobia, lacrimation.

Sialoadenitis is a lesion of the salivary glands. Manifested by fever, pain in the cheeks and ears, difficulty swallowing.

Acquired

Infection of an infant occurs at the time of childbirth, or in the following days and months through contact with a sick person or a virus carrier. Generalization of the process is very rare. The disease in this case proceeds non-specifically - a rise in temperature, an increase in lymph nodes, signs of inflammation of the tonsils. Perhaps a disorder of the stool, pain in the abdomen. Appetite worsens, increased salivation is noted.

More often there is a localized form of infection - with the defeat of any one system of the body:

• respiratory - the development of severe pneumonia (cough, shortness of breath, copious sputum);
• intestinal damage by cytomegalovirus - diarrhea, nausea, vomiting;
• urinary system - back pain, changes in urinalysis.

The disease lasts a long time, accompanied by high fever. The diagnosis is quite difficult to make.

In children of the first three years life, several clinical variants of the course of the disease are possible:

• sialadenitis - damage to the salivary glands;
• interstitial pneumonia;
• acute nephritis - kidney damage;
• acute intestinal infection;
• hepatitis;
• encephalitis with damage to the optic nerve, convulsive syndrome.

In older children, with already formed immunity, CMVI proceeds as an acute respiratory disease with a mild course:

• moderate temperature increase;
• malaise;
• swollen lymph nodes in the neck;
• sore throat.

Recovery occurs within 7-10 days without the development of complications.

If the infection occurred through breast milk, the baby will get sick only with a latent form of the infection, which is mild. This is due to the fact that with milk, children also receive a specific immunoglobulin that protects them from viral and bacterial infections.

Children attending organized children's institutions receive cytomegalovirus through saliva. This is usually implemented by airborne droplets.

Diagnostics

The diagnosis is made on the basis of the clinical picture, epidemiological history, and laboratory results. Since the clinical picture is nonspecific and similar to many other diseases, mandatory laboratory diagnostics are required to confirm CMVI.

The diagnosis is considered confirmed if either the virus itself or antibodies to it were found in any biological fluids of the baby. Cytomegalovirus cells are found in the urine, saliva, sputum, gastric lavage of the child. The most effective diagnostic method is PCR (polymerase chain reaction) - this method allows you to detect the genetic material of the virus in the test fluid.

If congenital CMVI is suspected, the detection of the virus or the analysis for antibodies to it in the mother of the child is of diagnostic importance.

Cytomegalovirus infection is considered one of the most common diseases associated with the penetration of a viral infection into a child's body. According to statistics, it is diagnosed in more than half of minors. In most cases, cytomegalovirus in children is asymptomatic and does not bring much harm to health.

If the baby's immunity is weakened or not yet fully formed, then the consequences can be severe. Therefore, each parent needs to remember the features of this disease and the sequence of its treatment.

What is a virus

Cytomegalovirus infection in children is caused by the penetration into the blood of a special virus, which belongs to the group of herpes viruses. You won't be able to get rid of it forever. Even after full therapy, it does not leave the body, but exists in a latent state. The disease in a latent form is diagnosed in 80% of people. In this case, infection occurs in early childhood or during pregnancy of a woman.

After the virus enters the baby's blood, it immediately rushes to the cells of the salivary glands. It is in this area that its localization is most often detected. The disease affects various organs and systems of the body: the respiratory tract, liver, brain, gastrointestinal tract.

Cytomegalovirus has the ability to integrate its DNA into the nucleus of a cell in the human body. This leads to the formation of new hazardous particles. Subsequently, they grow significantly. This is where the name cytomegaly comes from, which can be translated as a giant cell.

The disease is especially dangerous for children with insufficiently strong immunity. The risk group includes:

• Premature newborns.
• Children with congenital pathologies of development.
• Children with HIV infection.
• Children suffering from chronic diseases, such as diabetes, glomerulonephritis.

If a child with a strong immune system becomes infected, then nothing terrible happens. The disease does not show any symptoms.

How infection occurs

In the progression of cytomegalovirus in children, the path of infection penetration into the body is important. There are three main ways of infection:

• Intranatal. The infection enters the baby's body during its passage through the birth canal. If the mother has the virus in the active phase, then in 5% of cases it is transmitted to the child during delivery.
• Antenatal. Cytomegalovirus crosses the placental barrier while the baby is in the womb. With this course of events, the most serious consequences for the health of the child are observed. The virus lives in the amniotic fluid of an infected mother. It affects the digestive and respiratory systems of the fetus. If infection occurs in the first two trimesters, then there is a high probability of the appearance of congenital pathologies of the baby or miscarriage.
• Postnatal. Children become infected after birth. A baby can become infected through direct contact with an infected person. Transmission of the disease is possible with the milk of a sick mother. At a later age, cytomegalovirus in a child occurs upon contact with saliva, blood and other biological secretions of infected people. This situation often occurs in kindergarten, at school and other crowded places.

In adult children, compliance with the rules of individual hygiene plays an important role in maintaining health. Parents should teach the child to wash their hands as often as possible, not to put various objects into their mouths, and not to use other people's hygiene devices.

Normal course of the disease

Cytomegalovirus is not as scary as it might seem. If the child's immune system is healthy, then the disease does no harm. It doesn't show itself. In rare cases, symptoms similar to the course of SARS are observed. The following symptoms appear:

• Pain in the muscles.
• Headaches.
• The child quickly becomes tired, lethargic and drowsy.
• Chills appear.
• Runny nose.
• Lymph nodes increase in size.
• Increased salivation.
• A whitish coating may appear on the tongue and gums.

There are no dangers associated with this condition. After a couple of weeks, the symptoms of cytomegalovirus in children completely disappear. Simple antiviral drugs will help speed up the process, allowing you to transfer cytomegalovirus to a passive stage. Therapy with medicines for an infant should be carried out under the strict supervision of a specialist. Such carriage of the infection lasts until the end of life.

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The main symptoms and modern treatment of cytomegalovirus in women

What could be the symptoms

Symptoms and treatment are determined by the way the infection enters the body. With a congenital disease that was formed during the intrauterine development of the fetus, the following symptoms appear: hearing impairment, neurological abnormalities, decreased visual acuity, problems with the nervous system.

The manifestation of the virus immediately after birth is determined by the signs:

• Impaired vision and hearing.
• Eruptions on the skin.
• Seizures.
• The liver increases in size. The spleen also changes.
• Jaundice begins to appear.
• The child lags behind in development compared to his peers.

The cytomegalovirus virus in older children may not be diagnosed. If the child's immunity is weakened, then negative symptoms begin to appear:

• Pain in the joints.
• Intense headaches.
• Increase in body temperature.
• Rapid fatigue, drowsiness, loss of working capacity.

Symptoms may appear all at once or only some.

Diagnostic measures

Acquired and congenital cytomegalovirus can be accurately diagnosed only after a set of measures. A key role is played by laboratory tests of samples of biological material taken from a child. Most often, doctors use the following methods:

• Cultural. It consists in the isolation of cytomegalovirus from human cells. This method is considered the most accurate. It allows not only to detect the presence of the virus, but also to evaluate its activity. The only drawback of the technique is its duration. All studies take about two weeks.
• Cytoscopic. Using this method, enlarged cells are detected in the patient's saliva. A urine sample may also be used for research. This method is considered uninformative, therefore it is used infrequently. It is not always possible to detect cells in urine.
• Linked immunosorbent assay. The method allows to detect the presence of immunoglobulins M in the blood. Their presence in an infant indicates the initial stage of infection. In case of detection of immunoglobulins G, additional studies are prescribed. If there is an increase in the number of antibody titers, then we can talk about the progression of cytomegalovirus.
• Polymerase chain reaction (PCR) method. Considered the fastest. The result is considered as accurate as possible. Using the polymerase chain reaction, it is possible to detect the presence of DNA of a pathogenic virus. It is also possible to estimate the rate of its reproduction.
• X-ray examination of the chest. In the pictures, the attending physician will be able to consider signs of pneumonia that has appeared.
• Ultrasound of the abdominal organs. With CMV in children, during the study, the doctor determines the condition of the liver and spleen. Their increase in volume testifies in favor of the presence of cytomegalovirus. Children up to a year have their own characteristics of the location of the liver.
• MRI of the brain. With the development of the disease, the focus of inflammation will be detected in the pictures.

If a virus is detected during the study, the doctor decides how to treat cytomegalovirus. Parents must strictly adhere to all recommendations of a specialist.

Proper Treatment

For the treatment of cytomegalovirus in children, an integrated approach is used. Experts recommend the combined use of antiviral and immunomodulatory drugs. This therapy is considered safe for children over 3 years of age. In children under one year old, treatment is also carried out with the help of medications, but their dosage is calculated in a special way.

According to the recommendations of experienced specialists, including Dr. Komarovsky, the treatment of cytomegalovirus infection in children is carried out using the following drugs:

• Cycloferon, Viferon, Laferon and other analogues. They include interferon.
• Among immunomodulating agents, Imunofan, Ribomunil, Timogen are the most effective.
• Preparations of specific immunoglobulins. This group includes Neocytotec, Cytoga, Megalotect.
• Medicines, which include non-specific immunoglobulins: Intraglobin, Sandoglobulin.

If a doctor has detected a cytomegalovirus infection in a newborn that has entered the body after birth, then a symptomatic treatment regimen can also be used. It includes the use of the following drugs:

• Antibacterial agents. They are used only if an inflammatory process is found.
• Antipyretic drugs. For one-year-old babies, such funds must be carefully dosed. It is best to use drugs that are available in the form of suppositories.
• Hepatoprotectors. Together with CMV, a newborn may develop hepatitis. With the help of hepatoprotectors, liver cells are protected from damage.
• Vitamin and mineral complexes. They are designed to support the body's immune system.

Once in the baby's body, viruses do not manifest themselves immediately. They are waiting for the right moment. A factor in the development of infection is a drop in resistance - the body's resistance. Cytomegalovirus infection works in a similar way. The virus is usually discovered incidentally in a blood test.

The child receives CMV from outside or becomes infected even before birth, through the placenta. The congenital type of the disease is more difficult to tolerate and has a lot of complications, as a result of which the work of various organs and systems is disrupted. Treatment of the disease depends on the method of infection.

Why do children get sick with cytomegalovirus?

CMV belongs to a DNA-containing virus - Cytomegalovirus, which belongs to the herpesvirus family. It penetrates into all human organs, but it is mainly isolated from the salivary glands, where it actively multiplies and integrates its DNA into the nucleus of cells. Due to the foreign element, the cells of the salivary glands increase in size. Hence the name of the virus (translated from Latin - "giant cells").

With good immunity in a child, cytomegalovirus “IgG positive” is in an inactive state. This means that the child is only a carrier of the infection, but at the same time he does not get sick. With a decrease in the body's resistance, the virus begins to actively multiply, the body secretes specific antibodies and certain symptoms appear.

Additional factors that reduce the body's resistance are digestive problems and heavy loads on the fragile children's body, leading to increased fatigue. Against the background of a weakened immune system, the body becomes an easy target for infectious agents.

Factors that reduce immunity are:

• rehabilitation of the body after a protracted illness (for example, influenza);
• allergic reactions;
• birth trauma;
• vitamin deficiency;
• improper use of drugs;
• bad ecology;
• short period of breastfeeding newborns.

Types and symptoms of the disease

congenital infection

With intrauterine infection, clinical signs appear in children after birth. Symptoms of CMV infection include:

• Yellowness of the skin. Indicates hepatitis. Blood tests reveal elevated bilirubin.
• As a result of hepatitis, the liver and spleen may increase, as they are the first to react to an infectious agent in the body.
• High body temperature.
• Muscle weakness.
• There is a rash on the skin, bleeding ulcers are possible.
• Signs of general intoxication of the body.
• Enlarged lymph nodes (we recommend reading:).

• Swollen larynx, possible enlargement of the tonsils.
• Deterioration of breathing.
• Cyanosis of the skin (cyanosis).
• Sucking and swallowing reflexes are impaired.
• Digestive disorders, accompanied by vomiting and diarrhea.
• Loss of vision or hearing.
• Possibly pneumonia.
• Underweight.

Congenital cytomegalovirus infection in children can cause mental retardation. Sometimes the virus is fatal. The mortality rate of infected newborns reaches 30%. Also, due to infection, vision deteriorates up to blindness. If children with congenital cytomegalovirus do not show clinical symptoms, then subsequently 10-15% of these children will have hearing impairment.

Acquired infection

You can get cytomegalovirus only from a patient or from a carrier of the virus. Clinical symptoms of the disease appear when the body's resistance decreases. Often the disease resembles a common ARVI, as it is accompanied by signs of inflammation of the upper respiratory tract, cough and pain when swallowing. Nasal congestion and fever are also possible. As an additional clinical sign, a rash may appear all over the body in the form of red spots.

The lymphatic system reacts to the multiplication of an infectious agent by increasing the lymph nodes in the neck and under the lower jaw. They are painless, the skin over them looks unchanged.

If the baby complains of pain in the tummy, this is a symptom of an enlarged liver and spleen. Nearby lymph nodes - inguinal and axillary - can also increase. Yellowness of the whites of the eyes and skin indicate liver damage.

The sick baby becomes lethargic and drowsy. All signs of angina begin to develop. Children complain of pain in muscles and joints. Complications can be pneumonia or hepatitis. This picture is accompanied by neurological abnormalities in behavior.

How is CMV transmitted and who is the carrier?

In the external environment, cytomegalovirus in children enters along with biological fluids: saliva, secretions from the genital openings. Children become infected in the following ways:

• In utero. If during pregnancy an infection of the expectant mother occurs, then the cytomegalovirus infection enters the fetus through the placenta through the blood from the mother.
• With breast milk, if the nursing mother is ill with an acute form or has become infected already during breastfeeding.
• By airborne droplets when communicating with infected or carriers of the infection.
• Contact. A child can get the virus from the mother while moving through the birth canal.

In order for the virus to enter the body, you may not even have contact with a sick person. Biological secretions also pose a great threat to the health of the baby. The infection can be carried on dishes, personal hygiene items, door handles, etc. The contact method of transmission does not pose a threat to the life and health of the baby.

The carrier of the infection is a person who has no visible signs of the disease. However, it is dangerous for other people with reduced resistance. The infection is in the body in a latent state and is waiting for the right moment when the child's immunity decreases. Then the virus begins to actively multiply and infect the child's body.

How is the disease detected?

To make a diagnosis, it is not enough just to conduct an examination. The attending physician prescribes a number of tests:

• Serological blood test, in which specific antibodies are isolated. Isolation of IgM antibodies means that the infection has passed into an acute form (IgG protein is characteristic of the latent type).
• PCR will help detect the virus in saliva, urine and other body fluids.
• General blood analysis. It will show a decrease in the number of red blood cells, platelets and white blood cells (we recommend reading:).
• Biochemistry of blood. ALT and AST levels will be elevated, an increase in creatinine and urea will indicate kidney damage.
• Microscopic analysis of urine sediment for the presence of giant cells.

Cytomegalovirus IgG positive indicates a chronic course of the disease. Additional diagnostic methods include:

• X-ray with complications in the lungs will show pneumonia;
• An abdominal ultrasound will show an enlarged spleen and liver;
• MRI of the brain will reveal foci of inflammation.

An oculist examination is also possible. It reveals changes in the structures of the eye on the examination of the fundus in case of a generalized infection.

Is cytomegalovirus infection dangerous for children?

The infection is very dangerous for children who get it in infancy or were infected in utero. In 20% of cases, in those children whose infection is not accompanied by specific symptoms, the functioning of the nervous system is disturbed - anxiety, convulsions, and involuntary muscle contraction appear. Such children quickly lose weight, rashes on the skin are possible.

The consequences of cytomegalovirus can manifest themselves in a baby at 2 and 4 years old, and also after several years in the form of delayed speech and mental development, diseases of the cardiovascular system, impaired functions of the ear and visual apparatus, up to complete loss of vision and partial hearing loss. In older children, against the background of infection, the body's resistance sharply decreases. This provokes the development of bacterial microflora and causes other diseases, such as pneumonia or bronchitis.

How to cure the disease?

It is impossible to completely get rid of the virus, you can only bring it into an inactive state, therefore, therapy is aimed at eliminating the activity of the virus and reducing the consequences of infection of the body with pathogenic bacteria. used in pediatrics:

1. Ganciclovir. Active against many viruses, including CMV. The active substance of the drug is embedded in the DNA of the virus and inhibits its synthesis.
2. Acyclovir. Successfully fights all herpes viruses, including chickenpox. The principle of action is similar to antibiotics - slowing down and interrupting the chain of reproduction of the DNA of the virus.

The duration of treatment with antiviral agents is 2-3 weeks. When the clinical manifestations are completely stopped, and the test results show an inactive state of the virus, therapy is stopped.

Another group of drugs used in the complex treatment of cytomegalovirus is immunostimulants:

1. Isoprinosine (we recommend reading:). Stimulator of the body's immune forces. Suppresses the reproduction of RNA viruses. It activates the work that destroys abnormal cells, which is why it is used even in oncology. In the treatment of cytomegalovirus, it is often prescribed in parallel with Acyclovir to complement the action of the latter.
2. Viferon. The drug is based on artificially synthesized human interferon. Effective against herpes viruses. It is produced in the form of rectal suppositories and ointments and is used in cases where oral agents are contraindicated due to complications in the liver and digestive system.

As an addition to drug treatment, there are folk remedies. However, official medicine believes that they are useless in the fight against cytomegalovirus, so doctors do not recommend these recipes.

Preventive measures to prevent consequences

To avoid infection, you need to limit contact with patients. It is necessary to instill in the child the rules of hygiene and explain the need for thorough hand washing. If a healthy child was born to a mother infected with cytomegalovirus, breastfeeding should be completely abandoned.

In order for the child's immunity to be resistant to infections, it must be strengthened by a balanced diet containing all the main vitamins and microelements. Children with reduced resistance are given non-specific immunoglobulin, which contains antibodies to the virus.

It is necessary to strengthen the immune system in other, well-known ways: a healthy lifestyle, hardening, outdoor activities. Physical activity should be feasible - sport for the sake of results is as harmful as a sedentary lifestyle.

An infectious disease doctor is engaged in the fight against the disease, to whom the child should be shown if a virus is suspected. With various complications, it is also necessary to consult a neurologist, gastroenterologist, ENT specialist, ophthalmologist, nephrologist, pulmonologist. Comprehensive treatment depends on the type of complications.

In conclusion, we can say that you can not let the situation take its course and self-medicate. This will aggravate the disease and give a lot of complications that will affect the development of the child. It is also important to be screened for the carriage of cytomegalovirus during pregnancy and undergo appropriate therapy.