Usually a person is not aware that infection with cytomegalovirus has occurred, because there are often no symptoms with initial infection. Some people develop a flu-like syndrome when first infected, with fever, fatigue, muscle aches, headache, and mild liver inflammation. This can mimic mononucleosis, which is caused by another virus in the herpes family, the Epstein-Barr virus. But “mono” symptoms often include a sore throat and lymph node swelling throughout the body—symptoms that do not usually occur with CMV
Despite the mild symptoms (or the lack of symptoms), CMV infection can cause problems long after initial infection, sometimes several months or years later, particularly if a person’s immune system becomes damaged. For example, in persons who have suppressed immune systems—such as people with acquired immunodeficiency syndrome (AIDS) or people who have received organ transplants and are on immune-suppressing drugs—the virus can remain quiet, or it can be reactivated and cause sometimes devastating symptoms. These include infection of the retina of the eye (retinitis), the lung (pneumonitis) or the gastrointestinal tract (esophagitis or colitis). (See the entry for HIV infection and AIDS for more information about CMV infection in people with AIDS.)
Once again, most—more than 90 percent—are symptom free, but the symptoms can be devastating. If a woman who is in the first three months of pregnancy becomes infected for the first time, the chances of the baby becoming infected are 50 percent, and serious nervous system problems from CMV are possible at this stage in the development of the fetus. Possible consequences of infection in the newborn are liver infection and inflammation (hepatitis), retinal damage (which can lead to blindness), and skin rashes. Infants who are born symptom free sometimes develop learning difficulties and deafness in childhood.
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