cytomegalic inclusion disease (CID) [Gk, kytos + megas, large; L, in, claudere, in enclosure] , a viral infection caused by cytomegalovirus (CMV), a member of the herpesvirus family. There are three forms: CMV inclusion disease of the newborn; acute acquired CMV infection, which is similar to infectious mononucleosis; and CMV in immunocompromised persons. See also TORCH syndrome. ▪ OBSERVATIONS: Symptoms depend on the type of CID. When acquired in utero, results may range from spontaneous abortion or fatal neonatal illness to birth of a normal infant, depending on such factors as the virulence of the viral strain, fetal age when infected, and primary or recurrent nature of the mother’s infection. About 10% of newborns with congenital CMV show clinical signs, such as microcephaly, delayed growth, hepatosplenomegaly, hemolytic anemia, and pathological fracture of long bones. In 5% to 25% of asymptomatic infections, infants develop significant psychomotor, hearing, ocular, or dental abnormalities. In adults, it is often characterized by malaise, fever, lymphadenopathy, pneumonia, hepatosplenomegaly, and superinfection with various bacteria and fungi as a result of the depression of immune response characteristic of herpesviruses. ▪ INTERVENTIONS: Good hygiene is recommended to avoid transmission. Women who work with young children and are pregnant or planning to become pregnant are at high risk, especially if their first CMV infection is acquired during pregnancy. Antiviral drugs such as ganciclovir and acyclovir are used in immunocompromised patients to prevent infection or reduce viral load in infected patients. ▪ PATIENT CARE CONSIDERATIONS: CMV infections associated with organ transplant are now treated with cytomegalovirus immune globulin intravenous (human) (CMV IGIV). It is now also used for prophylaxis.
