Cytomegalovirus in pregnancy and its effects on the fetus Symptoms and methods...

Cytomegalovirus in pregnancy and its effects on the fetus Symptoms and methods of treatment of cytomegalovirus infection in children Cytomegalovirus is an agent of opportunistic infections from the category of herpesviruses. Its construction is similar to the viruses Herpesviridae and is able to remain in the cells of the body for life. Pathology converts glandular tissue, the cells of which become large, cytomegaly develops. We will examine in more detail the symptoms and methods of cytomegalovirus infection in infants.

Etiology of infection

The ways of infecting the baby's virus are specific and preferably depend on the health of the mother. For the sake of infection, hematogenous or long oral-bodily contact is needed. For the sake of determining the circumstances, first, an examination of a pregnant woman or a nursing mother. Infectionists divide the etiological prerequisites of CMV for two categories. Genetically infected infection occurs by such methods: through the placenta - transplacentary road; vertical infection in the process of baby's birth through microdamages for the skin; Aspiration - getting contaminated amniotic fluid in the baby's device to be born. The detected virus seeps into the device in such ways: breast milk of a cytomegalovirus mother carrier; through the bloodstream to be a transfusion; household road - through the secretion of the salivary glands of the carriers of the virus; contact infection - toys, objects, personal hygiene items, which were used by the carrier of infection; airborne variants of the invasion of the virus. The epidemiological characteristics show the totality of the spread of CMV and the growing morbidity rate every year: A born infectious disease is 0.1-0.3% per year of babies born. Cytomegalovirus infection in children is multifaceted, symptoms may not show for years, but in 15% of teenagers, virologists have antibodies to the virus. Serological screening indicates 58-59% of infection of children older than 5.5-6 years. Nearly 60% of cases of infection with the virus of a small child occurs through infected breast milk. In infants infected with CMV during the time of feeding, the action takes place in an erased form. Children are protected by passive visibility of immunity acquired with breast milk.

Symptoms

Clinical markers of the virus are unspecific. The first symptoms occur during the period of lowering the immune defense. If the baby is infected during the passage of the birth canal or through the milk of the mother, in 90% of the cases the pain is asymptomatic. Symptoms of a born cytomegalovirus infection: a hemorrhagic rash, small hemorrhages - in 80% of cases; the authority of the toddler's body is much less than the characteristics established by the Many; persistent jaundice in the compartment with an increase in the liver and spleen is observed in 70-75% of children with suspected infection; small size of the skull, microcephaly with sections of calcified tissue in the brain - every second baby; polyneuropathy - pathology of peripheral nerves; гидроцефалия; retinal inflammation of the eye; pneumonia of the newborn.Clinical manifestations of the acquired cytomegalovirus: For the background of vitamin deficiency, suppressed immune defense, mononucleosis can exist. Feverish good without impartial circumstances, pain in the limbs, lymph nodes, signs of tonsillitis, a small rash for the body. Active immunity and the presence of protective antibodies allow children to postpone the virus without discomfort. The presence of infection is determined in the blood test at random to be a routine examination. Symptoms of cytomegalovirus in babies are easily confused with signs of other diseases. Timely detection of titers of viral infection can prevent complications and transformation of infection into a generalized form.

Diagnosis

The detected IgG antibodies are not considered a clear diagnostic aspect of the first age of the baby's life, since most of the immunoglobulins of this class belong to the mother, and in the baby's blood gets again in utero, through the placental septum. The treating doctor often uses a plan combining PCR decomposition of biological media (saliva, blood, urine) and a test for viral load.Methods of diagnostic investigation of cytomegalovirus infection: In children at risk before the age of 21 days, blood, urine, tracheal washings, saliva, cerebrospinal fluid, part of the mother's fertile water for PCR decomposition, for nucleic acid hybridization are taken. The main indicators are antibodies in the cerebrospinal fluid and antigens in the blood. Serological studies (ELISA) are carried out at the newborn baby and his mother, tracking the dynamics of titles. An auxiliary method is cytology for the verdict of virus-infected cells. In the diagnostic activities are taken all the standard components - an image of a medical picture, anamnestic information, methods of observation and inspection. As necessary, ultrasound testing, universal decomposition of blood, immuno-fermentogram for the verification of cellular immunity may be recommended.

Healing and prevention

Healing of CMV is always a multicomponent combination of antiviral drugs and immunomodulating regimens. The therapeutic strategy of prenatal and acquired infection has differences. A pair of therapies combines one metaprocessing and neutralizing the activity of the infection in the detection zone of the virus. According to which the scheme and the way to cure cytomegalovirus decides the pediatrician to be involved infectious disease-immunologist, hematologist, neurologist, children's ophthalmologist.A greater danger for the sake of the baby's life is intrauterine infection, which is an unrealistic eradication of the pathogen. The choice of therapeutic measures should take into account not only the result, but also the possible dangers of post-medication complications in the newborn. The study of the innate cytomegalovirus infection implies a dose of such drugs: interferons - Tsikloferon, Viferon, Alpha-inzon, Laferobion, Laferon, Realdiron; immunomodulating drugs - Ribomunil, Immunal, Imunofan, Timogen; special immunoglobulins - Citogam, Neocytotect, Megalotect; nonspecific immunoglobulins - Pepaptlobin, Intraglobin, Sandoglobulin. Antiviral treatment includes a dose of antiherpetic drugs: Foscarnet, Atsivir, Ganciclovir, Acyclovir, Gepavirin, Valaciclovir. Symptomatic plan: drugs according to evidence for the healing of the inflammatory form of the concomitant disease; antipyretic pharmaceutical property at a dose of consent to age indices - orally or in the form of suppositories; hepatoprotectors; энтеросорбенты; probiotics, lactobiotics; disinfecting mixtures for the sake of irrigation of the oral cavity; vitamin therapy; supporting caloric order.Depending on the diagnosed type of cytomegalovirus in children, the symptoms and healing may be much different. The task of specific complex preparations depends on such criteria: the course of the disease is active or latent; secret danger of reactivation of the virus for the background of exacerbation of concomitant pathologies; type of infection - local, manifest, generalized; age, authority, health of the baby. Healing of cytomegalovirus infection in toddlers is carried out on the basis of clinical advice and an official protocol for assisting children with CMV infection. The healing strategy involves bed rest for the acute phase gap, a special high-calorie dose of nutrition and plenty of drinks. Pathogenetic and symptomatic therapy: detoxification with abundant vitaminized drink; according to evidence - infusion therapy with colloids (Reopoliglyukin), crystalloids (acesol, saline solution). More effective drugs in the scheme of treatment of CMV infection: antiviral - Viferon in the form of suppositories, Cytotect, Neocytotect, Ganciclovir, Citogam; additional pharmaceutical preparations - Cycloferon (solution). detoxifying property - Refortan, Reopoliglyukin. Surgical intervention is sometimes prescribed in cases of inherited pathologies of principally important organs. Indications for in-patient treatment are the activation of infection, the possible possibility of transition of the process to a generalized form. It should be borne in mind that most of the antiviral pharmaceuticals are very toxic for the gastrointestinal tract, liver, kidneys and circulatory system of the immature organism. Therefore, they are used very correctly and here only if the curative effect exceeds the risk of side intoxication. A prenatal measure in accordance with the prevention of CMV infection is considered to be clinical examination, premature detection of the virus in women to be conception planning and in the course of only the pregnancy period. To lower the risk of infection from a latent state to an active phase helps with such methods: Informing the nursing mother about the possible risks and ways of infection of the baby, rules of personal hygiene. Monitoring the state of immune protection before adulthood. Regular examination of the baby by an infectious disease doctor every 3 months before the service of a one-year-old. Serious restriction of contact with possible carriers of CMV. Children with diseases of the ENT organs (adenoid diseases, tonsillitis, recurrent ORZ), respiratory system, liver and digestive tract in acquired form should get a test for cytomegalovirus. Indicators of the success of antiviral treatment include the following characteristics: Decrease in activity of clinical signs. Detection of the highest level of avidity of anti-CMV IgG (antigen stability above 60%). The lack of Anti-Cytomegalovirus IgG, Anti-Cytomegalovirus IgM with a low level of avidity. Negative results of examinations for CMV antigen in the urine. Positive control examination after 6 and 12 months after the main therapeutic course. Good immunity, a healthy lifestyle, reasonable physical activity are the main barriers for the control of the virus in the body.