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Citomegalovirus: come si contrae? Come si cura?

Infezioni da herpes virus

Che cos’è il citomegalovirus?

Il citomegalovirus è un virus appartenente alla famiglia degli herpesvirus. L’infezione asintomatica è diffusa nel mondo intero, gli anticorpi specifici possono essere rinvenuti nel 40% della popolazione ed il virus è presente nella saliva, nell’urina, nello sperma, nelle secrezioni vaginali della donna soprattutto durante la gravidanza e nel latte materno. Il citomegalovirus si trasmette per contagio sessuale, in particolare negli omosessuali. L’infezione può essere contratta da trasfusioni di sangue massicce e manifestarsi dopo un periodo di incubazione di 4-8 settimane. Il virus può essere riattivato in caso di immunodepressione.

 

Quali sono i sintomi del citomegalovirus?

  1. Forma prenatale: la maggior parte delle infezioni transplacentari sono probabilmente asintomatiche. In  un piccolo numero di casi, l’infezione si manifesta con sintomi generali già dalla nascita: epatosplenomegalia con ittero, porpora, petecchie e sintomi neurologici (letargia, convulsioni).
  2. Forma postnatale: il bambino è infettato alla nascita dalle secrezioni vaginali della madre e l’infezione si manifesta dopo un periodo da 3 a 12 settimane.
  3. Forma acuta acquisita: l’infezione dell’adulto, è più spesso asintomatica ma può provocare febbre e a volte il quadro della mononucleosi infettiva.
  4. Forme polmonari: nei pazienti trattati con immunosoppressori, si possono osservare polmonite opportuniste gravi.

Diagnosi

Il sospetto clinico va corroborato dalla dimostrazione del virus o di suoi componenti piuttosto che degli anticorpi specifici di classe IgG e IgM, di solito con tecnica immunoenzimatica. Il sospetto di infezione primaria può essere confermato dalla presenza di IgM specifiche e in qualche caso dall”aumento da 2 a 4 volte del titolo IgG specifiche in prelievi successivi. Nelle altre forme cliniche  da citomegalovirus la sierologia  non è di regola utile.

 

 

Come si cura il citomegalovirus ?

I farmaci attivi contro il citomegalovirus sono: ganciclovir, valganciclovir, foscarnet e cidofovir. Sono terapie da eseguire sempre sotto controllo specialistico per i frequenti effetti collaterali anche gravi. Nei pazienti immunocompromessi occorre spesso far eseguire ai trattamenti di induzione lunghi periodi di terapia soppressiva a dosaggio ridotto finché persiste lo stato di immunodeficienza.

 

Leggi anche:

 

Varicella: sintomi, diagnosi e complicanze 

Mononucleosi infettiva: sintomi , diagnosi e complicanze

Fuoco di Sant’ Antonio- Herpes Zoster

 

Home » Citomegalovirus: come si contrae? Come si cura?

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