Cytomegalovirus esophagitis
* Introduction
* Signs and symptoms
* Diagnosis
* Treatment
Cytomegalovirus is a member of the family Herpesviridiae with herpes simplex virus, Epstein-Barr virus, varicella-zoster. Like other herpes viruses, CMV replicates in the host cell nucleus and has the ability to produce a latent infection. Replication is characterized by large intranuclear and intracytoplasmic inclusions small.
Studies have shown that 50-80% of the world population is infected with CMV. The incidence of infection is highest around the age of childhood and adolescence. Esophagitis with uveitis, adrenalita, pneumonia and colitis infections are immunocompromised persons.
Esophagus is the second location of CMV infection in the digestive tract after colitis.
Pathogenesis
The first infection with CMV infection is exposure and a seronegative patient who is HIV positive. This is your replacement mechanism 60% of patients. Primo-infection in immunocompetent hosts cause few symptoms or is asymptomatic. Studies show that CMV persists in latent form in most body organs.
The second mechanism is reactivated, it occurs in patients seropositive for latent virus becomes reactivated from imunocompromiterea host. It is valid for 10-20% of cases.
The third mechanism is superinfection, which occurs in 20-40% of patients. A patient is seropositive for CMV and receives cells from another person infected with HIV. Infection is caused by viruses and not from individual donor own.
Once a person becomes infected, CMV can persist in the host indefinitely. Humoral and cellular immune mechanisms conspire to control the infection and maintain latency phase. If the host response becomes ineffective, undermining other diseases secondary, latent virus is reactivated and cause various clinical syndromes.
Causes and risk factors: -HIV / AIDS -Dose corticosteroid therapy regardless of Immunosuppressive therapy after transplant- -Infected blood transfusions -Old age Blood-solid neoplasms Long-term dialysis.
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