The Best Practices for Screening, Monitoring, and Diagnosis of Cytomegalovirus Disease, Part I

Human cytomegalovirus (CMV), a ubiquitous member of the herpesvirus family, is an important human pathogen. Infections are usually asymptomatic but can be associated with a wide spectrum of diseases, particularly in immunocompromised persons. Primary infection during pregnancy may result in congenital infection leading to severe damage of the fetus. Intrauterine primary infections are second only to Down's syndrome as a known cause of mental retardation. CMV infection in transplant recipients may cause different clinical syndromes in different groups of patients, and the severity of the infection parallels the degree of immunosuppression.As infections are either asymptomatic or accompanied by symptoms that are not specific to CMV (such as fever and leukopenia), laboratory techniques are the sole means of diagnosing CMV infection. Diagnosis of CMV infection can be made directly by demonstration of the virus or virus components in clinical samples or indirectly through serology. Part I of this article reviews infections in immunocompromised patients and the various approaches to monitoring and laboratory diagnosis of CMV infection.