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Cytomegalic inclusion disease was found in a 5-week-old infant who died unexpectedly. Myocarditis was observed; it was believed to be the cause of this unexpected death.
Cytomegalic inclusion disease due to a virus of the herpes groups, which was first cultured in 1956 by Margaret Smith, is not only the disease of new-born known in France since 1952. Among the clinical pictures suggestive of this infection, one should include mononuclear syndromes with a negative Paul and Bunnell test which accompany cytomegalovirus viremia and a rise in specific antibodies.
The clinicomorphological manifestations of iatrogenic thesaurismosis that developed because of infusion therapy of patients with plasma substitutes were studied using autopsy and operative material from 44 deceased and 2 operated children aged 1 month to 3 years. An experimental disease was obtained in 16 rabbits. Cytomegalia was discovered in 23 deceased children with iatrogenic thesaurismosis and sepsis in 18 children. In 12 cases, sepsis was of iatrogenic nature. An assumption is worded about the three-member family of those diseases undergoing substantial pathomorphism.
The case report concerns a 2 years old girl with hypoproteinemia associated with gastritis. The child recovered completely 8 weeks later. Cytomegalovirus was excreted in urine. The authors suggest that such a clinical picture should not be called Menetrier's disease. The role of cytomegalovirus is discussed.
Cytomegalic inclusion disease (C.M.I.) is caused by the salivary gland virus which is species-specific, and characterized by formation of inclusion-bearing cells in various organs. From the view point of spreading, it is divided into the localized and generalized type. We studied 18 generalized cases of infants in whom inclusion-bearing cells were detected in more than three organs. As to the portal of entry and the time of infection, cytomegalic inclusion disease can be classified into three subgroups in infants; congenital form (2 cases), early acquired form (8 cases) and acquired form with other debilitating diseases (8 cases).
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Congenital cytomegalic inclusion disease occurring in two infants who received intrauterine transfusions for severe haemolytic disease due to rhesus isoimmunization may have been transmitted in the donor blood.
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A newborn infant with congenital cytomegalic inclusion disease had spontaneous fractures of the distal radii bilaterally, and involvement of the metaphyseal portions of the humeri, ulnas, femurs, and tibias. The fractures healed promptly without complications under ordinary management. At the present time, one can only speculate on the cause of these lesions. Viral osteomyelitis, osteomalacia secondary to hepatitis and malabsorption and a disturbance of endochondral ossification are all possibilities. There is a need for additional cases with histologic and biochemical studies of the bone lesions in congenital cytomegalic inclusion disease.
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A case of disseminated cutaneous cytomegalic inclusion disease associated with Hodgkin's disease is described. The patient had a diffuse eruption of pruritic, erosive erythematous nodules. Histologically, many inclusion bodies were observed in perivascular areas of the skin lesions. Immunohistologically, the inclusion bodies positively stained with both anticytomegalovirus antibody and anti-factor VIII-related antibody. On electron microscopy many virus particles and dense bodies were found in the area where inclusion bodies were observed. Treatment with high-dose intravenous acyclovir and a large amount of immunoglobulin resulted in prompt healing of the skin lesions. Subsequently, the patient's Hodgkin's disease was well controlled on chemotherapy. The patient steadily improved without relapse of skin lesions 1 year after antiviral therapy was administered.
Mucosal cytomegalic inclusion disease (CID) is a serious complication in acquired immune deficiency syndrome (AIDS) that usually is associated with disseminated cytomegalovirus (CMV) infection, and leads progressively to death in many patients. Early diagnosis may improve the chances of responding to specific antiviral therapy. We analyzed retrospectively the diagnostic evaluations of 26 AIDS patients with histopathologically confirmed CID infections and 19 AIDS or AIDS-related complex patients without CMV infections. The groups were similar demographically and clinically. Characteristic CMV inclusion bodies were found on antemortem biopsy in 92% of patients, including 80% for rectal biopsy alone. The specificity of the viral inclusions for CMV was established using an immunohistological technique. Rectal culture for virus isolation was much less sensitive (30%) than biopsy. Urine cultures were positive more frequently (39%) than were rectal cultures, but were less specific. Furthermore, the presence of immunoglobulin G anti-CMV was nonspecific and the presence of immunoglobulin anti-CMV was both insensitive and nonspecific. We conclude that mucosal biopsy is a rapid and reliable means of detecting cytomegalovirus infections, and is an indispensible part of the evaluation for this disease.
We report the case of a female infant born with cytomegalic inclusion disease, in whom bone changes were present in x-rays of the tibiae and femora. She was the mother's first child and was born 8 days postmature after a normal delivery; birthweight 2.52 kg. Many infarcts were seen in the placenta. The mother had a feverish illness at the 7th month of gestation, diagnosed by family doctor as influenza. No drugs had been given.
A case is presented of pulmonary cytomegalic inclusion disease in adult. The condition was only diagnosed post mortem. A detailed description of the inclusions and inclusion-bearing cells is given. Histochemical observations which reveal an outer and inner zone to the intranuclear inclusion body are confirmed. Electron microscopy shows the viral basis of the infection. The morphology of the virus particles is compatible with a herpesvirus infection.
The successful propagation of porcine cytomegalic inclusion disease virus (inclusion-body rhinitis virus) in primary pig lung cell cultures is reported. CID virus was carried through five passages in cell cultures with cytopathic affects appearing from 11 to 18 days post-inoculation. Four pigs inoculated with infected cell culture fluids from the second cell culture passage remained clinically normal. Two, however, had typical inclusion bodies in the glands of the nasal mucosa when examined three weeks post-inoculation. The progressive cytopathic effect produced and the inclusion bodies formed by this strain of porcine CIDV are described. These inclusion bodies appeared to be similar to those formed by cell culture-propagated cytomegaloviruses of man, mouse and guinea pig.
Infection with the human cytomegalovirus has a teratogenic effect on the fetus during the first trimester of gestation as does rubella. Since unusual dermatoglyphic findings have been observed in infants with congenital rubella infection, the present study was designed to determine whether or not unusual dermatoglyphics occur in patients with cytomegalic inclusion disease of infancy. Analysis of dermatoglyphics in 15 infants with cytomegalic inclusion disease revealed unusual features in all infants. These features are reported here for the first time and are compared with dermatoglyphic findings in a normal population as well as with those of available parents of the infants.
An autopsy case of adult T-cell leukemia with generalized cytomegalic inclusion disease and pneumocystis carinii pneumonia is reported. Tumor cells had T-cell characteristics (E-rosette) and cerebriform nucleus similar to Sèzary cells. Generalized lymphadenopathy, hepatosplenomegaly and an ectopic pancreas in the ileum were found at the time of autopsy. Histologically, leukemic infiltration was observed in almost every organ, and perivascular infiltration, vascular invasion were conspicuous findings. Cytomegalic inclusion bodies were observed in most organs (lungs, salivary glands, pancreas, liver, ectopic pancreas, sweat gland, stomach, thyroid gland, pituitary body, etc.). An acute hepatitis, probably caused by cytomegalovirus, was also noted. Presumed correlation of adult T-cell leukemia, cutaneous T-cell lymphoma and T-cell lymphoma was discussed.