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Acquired cytomegalovirus infection in children

Gail J Demmler-Harrison, MD
Section Editors
Morven S Edwards, MD
Leonard E Weisman, MD
Deputy Editor
Carrie Armsby, MD, MPH


Cytomegalovirus (CMV) is a ubiquitous virus that commonly infects people across the spectrum of all ages, races, and ethnic groups, and those from a variety of socioeconomic, cultural, and geographic backgrounds. Although most CMV infections are asymptomatic or cause mild disease, the virus can cause serious disease in newborns and immunocompromised children [1]. Discerning which role, if any, CMV is playing in a disease process, as well as the need for treatment, can be difficult because of its ubiquity (table 1). Such decisions require a thorough knowledge of CMV virology, epidemiology, clinical manifestations, laboratory diagnosis, and indications for treatment.

Postnatally acquired CMV infection in infants, children, and adolescents will be reviewed here. Congenital CMV infection is discussed separately. (See "Congenital cytomegalovirus infection: Clinical features and diagnosis" and "Congenital cytomegalovirus infection: Management and outcome".)


Cytomegalovirus (CMV) is a member of the Herpesvirus family, along with Epstein-Barr virus (EBV); herpes simplex viruses (HSV)-1 and 2; varicella-zoster virus (VZV); and human herpesviruses (HHV)-6, -7, and -8. These viruses all share properties, including a genome of double-stranded linear DNA, a virus capsid of icosahedral symmetry, and a viral envelope [2]. They also share the biological properties of latency and reactivation, which cause recurrent infections in the host.

CMV is a member of the subfamily beta Herpesviridae, which also contains HHV-6 and -7. CMV will replicate slowly, often taking as long as 24 hours to produce virus progeny in infected cells and several days to weeks to produce visible cytopathic effect in laboratory cell lines (picture 1). No distinct serotypes of CMV exist; however, strain differences can be detected by molecular analysis of DNA, providing a classification of genotypes [3].


Infection with cytomegalovirus (CMV) occurs commonly; seroepidemiologic studies have shown the prevalence of antibody to CMV is influenced by age, geography, cultural and socioeconomic status, and child-rearing practices. In developing countries, most children are infected by three years of age, whereas in developed countries, such as the United States or United Kingdom, infection occurs throughout childhood and adolescence, with as many as 60 to 80 percent of the population infected with CMV by adulthood [1].

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Literature review current through: Oct 2017. | This topic last updated: Sep 29, 2016.
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