Cytomegaloviruses, also members of the herpes group, are ubiquitous. Eighty percent of adults have serum complement-fixation reactivity for these viruses. The most severe outcome of infection with cytomegalovirus is destruction of the immature central nervous system in neonates. Cytomegalovirus also appears to produce mononucleosis similar to infectious mononucleosis but without adenopathy or tonsillopharyngeal involvement. Liver involvement may mimic that of the more common forms of viral hepatitis, but it is usually mild and does not progress to chronic liver disease.
Diagnosis requires inoculation of an appropriate tissue culture with urine to demonstrate viruria.
Complement-fixation or indirect hemagglutination titers also increase after an attack. Acute hepatitis caused by herpes simplex or varicella virus, usually accompanied by typical skin lesions, has occurred in immunocompromised patients.