Which physical findings are characteristic of cytomegalovirus (CMV) infection?

Updated: Jul 07, 2021
  • Author: Ricardo Cedeno-Mendoza, MD; Chief Editor: Michael Stuart Bronze, MD  more...
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Most patients with CMV infection exhibit few clinical findings on physical examination.

Primary CMV infection may be a cause of fever of unknown origin.

Symptoms, when apparent, develop 9-60 days after primary infection.

Pharyngitis may be present.

Examination of the lungs may reveal fine crackles.

The lymph nodes and spleen may be enlarged, so CMV should be included in the differential diagnoses of infections that produce lymphadenopathy.

Many physicians believe that CMV mononucleosis is less associated with pharyngitis and cervical adenopathy than EBV infectious mononucleosis. A recent study in young children questioned the accuracy of this clinical pearl. The study found that cervical adenopathy was more common in patients infected with EBV than in patients infected with CMV (83% versus 75%). Although statistically significant, relying on this sign for the differentiation between CMV and EBV mononucleosis is difficult.

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