• Notice the numerous cleanly punched out ulcers that occur in the case of an acute CMV infection in an immunocompromised individual.

•Cytomegalovirus is a herpes virus that is ubiquitous in human populations.

•Viral infection causes cell necrosis.

•Epidemiological studies indicate that 1% of newborns are infected via the placentally, and about 5% more acquire the infection at the time of birth.

•There is a steady increase in the number of individuals with antibodies in the serum, and this number takes a significant jump at the time of adolescence, presumably due to transfer of virus through the oral route.

•CMV may also be sexually transmitted

•CMV is a major cause of morbidity in patients with AIDS.

•Infection may be acquired trans-placentally, around childbirth, through mother^s milk, or through various forms of tissue and body fluid transfer.

•Most individuals have a mild flu-like episode upon initial infection.

•The virus subsequently becomes latent and persists in many tissues of the body.

•In immunocompromised individuals, however, reactivation and involvement of almost any organ of the body can take place.

•A common subclinical infection is in the salivary glands, and for this reason the virus was once referred to as the "salivary gland virus."

•Trans-placental transfer results in a syndrome that includes extensive damage to the developing brain, chorioretinitis and pneumonitis.

•In the skin, cytomegalovirus can cause sharply punched-out ulcers.

•Histologically, affected cells are enlarged, with large intranuclear inclusions with a typical halo around them.

•There is relatively little acute inflammatory reaction to the viral infection.

•Infected cells contain large intranuclear inclusions that are around 10 nanometers in size, as well as small intracytoplasmic inclusions (around 3 nanometers in size).

•Cells that are productively infected and bearing inclusions tend to be significantly larger than surrounding cells.

• Robbins Pathologic Basis of Disease, 7th ed. 2005, pp. 366-368.

• Harrisons Principles of Internal Medicine. 2005, Ch. 166.

• Current literature from PubMed at National Library of Medicine