TABLE 4.
Clinical and laboratory manifestations of nonocular cytomegalovirus (CMV) disease*
| Affected area | Disease | Clinical and laboratory manifestations/indicators |
|---|---|---|
| Gastrointestinal tract | Colitis | • Abdominal pain |
| • Fever | ||
| • Weight loss | ||
| • Diarrhea | ||
| • Gastrointestinal bleeding | ||
| • Concomitant CMV retinitis | ||
| Esophagitis | • Odynophagia | |
| • Retrosternal pain | ||
| • Dysphagia | ||
| • Weight loss | ||
| • Classic endoscopic picture of shallow ulcers, usually in the distal one-third of the esophagus | ||
| • Concomitant CMV retinitis | ||
| Central nervous system | Polyradiculitis | • Guillain-Barre-like presentation (except for anal sphincter involvement and sparing of upper extremities) |
| • Ascending lower motor neuron weakness of legs | ||
| • Loss of sphincter function | ||
| • Cerebrospinal fluid: Increased polymorphonuclear leukocytes, increased protein, a slight decrease in glucose; positive for CMV-DNA using polymerase chain reaction | ||
| Encephalitis | • Confusion | |
| • Decreased level of consciousness | ||
| • Cognitive impairment | ||
| • Headache | ||
| • Seizures | ||
| • Fever | ||
| • Periventricular enhancement on infused computed tomography scan | ||
| Neuropathy | • Numbness or burning of the skin | |
| • Allodynia, especially in feet and lower extremities | ||
| • Decreased reflexes, weakness | ||
| Respiratory tract | Pneumonia | • Cough |
| • Dyspnea | ||
| • Fever | ||
| • Interstitial infiltrates on x-ray |
*
CMV infection can also rarely cause adrenal insufficiency and sclerosing cholangitis (HIV cholangiopathy). CMV may also cause a nonspecific febrile syndrome, with markers of active CMV replication in the blood and usually mild to moderately low neutrophil and platelet counts