Pathogenesis (disease development)
When the body is infected with cytomegalovirus – DNA virus of the herpes group – infection of the parotid gland (parotid gland) occurs, but it goes unnoticed. The virus spreads further in the body and infects all organs. Interstitial lymphoplasmacytic inflammation occurs with giant cells and nuclear (“located in the nucleus”) inclusion bodies (“owl eye cells”).The virus persists for life, meaning that once infected, the virus remains in the body for life and can lead to re-infection if the immune system weakens.
Diaplacental infection (infection via the placenta/uterine placenta) is possible.
Depending on the gestational age (age at pregnancy), the maternofetal transmission rate (transmission from mother to unborn child) was 30% in the first trimester (third trimester), increasing to 38 and 72% in the second and third trimesters, respectively. Transmission (“transmission”) is equivalent to fetal infection, regardless of the clinical course.
Etiology (Causes)
Behavioral causes
- Close personal contact
- Intimate physical contact
- Living in community facilities
- Poor personal hygiene
Medication
- Immunosuppressants (substances that reduce the functions of the immune system) (= reduction of T-cell-mediated immunity and, as a result, an increased risk of viral and mycotic (fungal) infections).
Other causes
- Blood transfusions
- Breast milk from a CMV-positive mother
- Transplanted, immunosuppressed patients (organ transplant; stem cell transplant); CMV infection due to:
- Primary infection of a seronegative organ recipient by a seropositive organ donor (“mismatching”).
- Secondary infection by reactivation of a latent CMV infection.
- Transmission through close physical contact with an infected person (see below “Behavioral causes”).