Acquired Cytomegalovirus Infection in Older Children and Adults: A Clinical Study of Hospitalized Patients

Abstract

Over a 3-year period (1966–1969) at least 17 patients with cytomegalovirus (CMV) infection were hospitalized at the University Clinic for Infectious Diseases, Danderyd Hospital. A significant rise in titre of complement-fixing (CF) antibodies against CMV occurred in 14 patients and 2 of them were shown to excrete CMV in their urine. Another 3 patients also excreted CMV but none of them showed a rising CF titre, although 2 had a high (≥ 80) titre against the isolated agent. The age of the patients ranged from 6 to 71 years, 2 were younger than 19 years. The sexes were evenly distributed. Most patients were previously healthy. The mode of transmission of the CMV in these cases was not established. Blood transfusions given 3–6 weeks before onset of the present illness might have been the mode of transmission in 5 cases. A high and often spiking, long-lasting fever dominated the clinical picture. The physical examination of the patients most frequently revealed very few abnormal findings. However, in a few cases anginose or lymphoglandular types of infectious mononucleosis were seen. Three patients had pneumonia, 2 had myocarditis and 1 meningoencephalitis. Splenomegaly was not observed. Hepatomegaly was noted in 4 patients, but all patients had a slight rise in one or several of the liver function tests, mostly of SGOT and SGPT. Atypical lymphocytes (7–59%) were found in the peripheral blood of 9 patients and a predominance of polymorphonuclear cells in 3 patients. Only 1 patient was critically ill. All patients survived.