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Biomedical subjects

M L Kumar

Publications and source records attributed to M L Kumar.

49 records · Page 3Linked to original sources
PubMed1984

A prospective study of maternal cytomegalovirus infection and its effect on the fetus.

In order to define the effects of maternal cytomegalovirus infection in pregnancy and to identify risk factors associated with delivery of a cytomegalovirus-infected infant, a cohort of 1089 adolescents were prospectively evaluated during pregnancy. One hundred twenty-four subjects (11.4%) manifested cytomegaloviruria during pregnancy. Primary cytomegalovirus infection, defined virologically and serologically, occurred in three subjects. Infants of 119 cytomegalovirus-excreting mothers were cultured at birth, with detection of 12 congenital infections (10%), including one infant delivered of a mother with a third-trimester primary infection. A high titer of urinary virus or a fourfold or greater increase in antibody during the third trimester was significantly associated with delivery of a congenitally infected infant. All maternal and infant infections were asymptomatic. None of the congenitally infected infants manifested adverse effects during the first year of life. Our data demonstrate that pregnant women with cytomegaloviruria are at increased risk of being delivered of congenitally infected infants, particularly if active infection occurs late in pregnancy. If the maternal infection represents reactivation, overall probability of a poor fetal outcome is low.

Adolescent↗
PubMed1984

Postnatally acquired cytomegalovirus infections in infants of CMV-excreting mothers.

A prospective study of cytomegalovirus-excreting pregnant women allowed us to identify a group of infants at high risk of acquiring CMV infection. Eighty-one infants free of CMV infection at birth were observed during the first year of life. Twenty-one became infected with CMV; 16 (76%) of these were detected within the first 14 weeks of life. Placental cultures from two of the 21 infants were CMV positive. The geometric mean cord blood antibody titers of postnatally infected and uninfected infants did not differ significantly. Clinical symptoms, including hepatosplenomegaly, lymphadenopathy, or pneumonia, occurred in association with CMV infection in seven infants. Postnatally acquired CMV infections can be symptomatic, and by virtue of their prevalence, constitute an important health problem.

Adult↗
PubMed1984

Congenital and postnatally acquired cytomegalovirus infections: long-term follow-up.

To determine long-term outcome of children with inapparent congenital cytomegalovirus infection, an assessment of congenitally infected children observed since birth was undertaken. Children with early postnatal acquisition of CMV infection were also evaluated. Cognitive, behavioral, neurologic, audiometric, and speech and language evaluations were performed in 48 patients, including 17 congenitally infected children, 10 children with postnatal infection, and 21 uninfected control subjects. Mean IQ of the three groups of children did not differ significantly. Behavioral, neurologic, speech and language examinations similarly failed to distinguish differences among the three groups. Audiologic abnormalities were present in four congenitally infected children, including one child with a severe unilateral sensorineural loss; in none of the children was hearing loss functionally significant. No hearing abnormalities were detected in postnatally infected children. Although inapparent CMV infection can result in audiologic sequelae, the continued lack of cognitive, behavioral, and neurologic sequelae in these school-age children reemphasizes the need to focus attention on prevention of primary maternal CMV infection to avoid the potentially devastating effects of intrauterine CMV infection.

Audiometry↗
PubMed1984

Primary cytomegalovirus infection in adolescent pregnancy.

In a prospective study of 3,253 pregnant adolescents, 1,404 were seronegative for cytomegalovirus (CMV). Specimen collection at each antenatal visit, including urine for viral culture and serum for complement-fixing antibody, allowed definition of primary CMV infection in 14 subjects (1%). Seven of 14 subjects delivered congenitally infected infants, including 5/7 subjects with third trimester infections, and 2/5 subjects with second trimester infections. The single mother with a first trimester infection delivered an uninfected infant, despite recurrent maternal viremia. The mean birth weight of congenitally infected infants did not differ significantly from the mean birth weight of uninfected infants. None of the infants had stigmata of cytomegalic inclusion disease. One infected infant died suddenly at 6 weeks of age from pneumonia. Follow-up examinations of the six living children failed to detect cognitive, behavioral, or audiologic sequelae. These data demonstrate that primary maternal CMV infection occurs in 1% of susceptible women and is associated with a 50% risk of intrauterine infection. Fetal infection, particularly if it occurs late in pregnancy, is not invariably accompanied by fetal damage.

Adolescent↗
PubMed1983

Experimental primary cytomegalovirus infection in pregnancy: timing and fetal outcome.

In contrast to intrauterine rubella infection, the relationship between timing of maternal cytomegalovirus (CMV) infection and fetal outcome has not been clearly defined. In order to investigate this relationship, a guinea pig model was utilized to assess the fetal consequences of maternal CMV infection during the first, second, or third trimester of pregnancy. Congenital infection occurred in 24 of 35 newborn guinea pigs (69%) delivered to mothers infected during the third trimester, with localization of virus to salivary gland in 17 of the 24 infected newborn guinea pigs. In contrast, only one of 28 (5%) progeny sacrificed following first-trimester maternal infection was congenitally infected (p less than 0.01). Second-trimester maternal infection was associated with an intermediate risk of intrauterine infection with transmission of virus to 17 of 54 progeny (33%) (p less than 0.01). Eight of the 10 fetuses delivered after second-trimester infection had virus in multiple organs including the brain. These data suggest that timing of maternal CMV infection is an important variable affecting fetal outcome, with increased risk of intrauterine infection when maternal infection occurs late in pregnancy. However, if fetal infection occurs earlier in pregnancy, it appears to present a greater threat to the fetus, with the potential for dissemination of virus in multiple fetal tissues, including the brain.

Animals↗
PubMed1979

Cytomegalovirus infections.

Cytomegalovirus infections are common throughout the world. Certain populations, including pregnant women and their fetuses, immunosuppressed patients, and recipients of large amounts of transfused blood, are at increased risk. Although the majority of infections in all groups of patients are clinically inapparent, variable symptoms, including fever, rash, pneumonitis, and hepatitis, can occur. The infected host develops antibodies against CMF, but frequently, despite this appropriate immune response, infection becomes chronic with prolonged excretion of virus. In some instances, a latent infection, with disappearance of virus, develops and under a variety of circumstances, including immunosuppression, infection can later be reactivated with reappearance of viral excretion. The human consequences of latent infection with CMV are not yet fully appreciated, and future research on this virus with multifaceted potential will need to focus on this issue.

Adult↗
PubMed1978

Experimental congenital infection with cytomegalovirus: a guinea pig model.

An animal model permitting study of congenital infections with cytomegalovirus (CMV) has been developed in guinea pigs. Fifteen Hartley strain guinea pigs in the latter half of pregnancy were inoculated intraperitoneally with 10(5.5) 50% tissue culture infective doses of guinea pig CMV. Forty percent of infected mothers delivered litters containing at least one infected newborn, as defined by a positive culture of lung, spleen, or brain. All tissues were cultured by an explant technique. The three mothers who had no detectable complement-fixing antibody to CMV prior to experimental infection delivered infected litters, whereas three of 12 immune mothers delivered infected litters (P less than 0.01). A low-passage, tissue culture-adapted virus produced neonatal infection as frequently as did salivary gland-passaged virus. No congenital abnormalities were found in any of the seven infected newborns. CMV was isolated from lung, spleen, or brain in the four newborns of nonimmune mothers; CMV was isolated from lung only in the three newborns of immune mothers. These preliminary experiments demonstrate that the guinea pig is a suitable animal for further study of maternal-fetal CMV infections.

Animals↗
PubMedDate not supplied

Acquisition of cytomegalovirus infection in infants following exchange transfusion: a prospective study.

A prospective study of newborn infants who required exchange transfusion was undertaken to evaluate the risk of transmission of cytomegalovirus (CMV). Buffy coat-, urine- and saliva-saturated throat swabs for viral cultures and serum specimens for CMV complement-fixing (CF) antibody were obtained from 45 infant-mother pairs. Buffy coat from the donor blood was cultured and CMV CF titers measured. Viral studies were repeated on infants and mothers at six and 12 weeks after exchange transfusion. Fifteen infants received CMV seropositive blood and 14 infants received CMV seronegative blood. Sixteen infants who did not receive blood or blood products served as controls. Three of 12 antibody-positive newborns developed infection after getting seropositive blood. One of three antibody-negative newborns developed infection after getting seropositive blood. The presence of transplacental antibody does not appear to protect the infants. None of the control infants developed CMV infection. None of the infected infants were symptomatic. Although CMV infection in infancy can be acquired by routes other than blood, exchange transfusion with seropositive blood enhances the likelihood of acquiring infection.

ABO Blood-Group System↗
PubMedDate not supplied

Branhamella catarrhalis pneumonia with bacteremia in a pediatric patient with smoke inhalation.

Branhamella catarrhalis, a common inhabitant of the upper respiratory tract, has been identified recently as a cause of lower airway infection. In this report we present a case of B. catarrhalis pneumonia and bacteremia in a child with smoke inhalation as the first description of invasive disease involving this organism in a traumatized airway. In addition, other pediatric cases of B. catarrhalis bacteremia are reviewed, suggesting immunocompromise as a risk factor.

Anti-Bacterial Agents↗