COEXISTENT CYTOMEGALIC INCLUSION DISEASE AND PNEUMOCYSTIS CARINII INFECTION IN ADULTS.
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The salivary glands from three African hedgehogs contained multiple foci of cytomegalic cells, which occasionally had a mild to moderate infiltrate of lymphocytes at the periphery. The cytomegalic cells were 35 to 40 microns in diameter with abundant acidophilic granular to hyalin cytoplasm. The nuclei were enlarged with clumped marginalized chromatin and a large, (6 to 8 microns in diameter) central, brightly eosinophilic nucleolus that had the appearance of an inclusion body by light microscopy. Histochemically most of the cytomegalic cells contained cytoplasmic metachromatic granules with Feyrter's thionine inclusion stain. Scattered cells at the periphery of the cytomegalic foci contained periodic acid-Schiff-positive cytoplasmic granules. Ultrastructurally the cytomegalic cells contained numerous tightly-packed, often bizarre, enlarged mitochondria that completely filled the cytoplasm. The nucleus consisted of a dense central core of chromatin associated with the nucleolus and the remaining chromatin was clumped and marginalized. Nuclear and cytoplasmic virions consistent with cytomegalovirus were not present. Histochemical stains of the nucleus for heavy metals were negative. The ultrastructural and histochemical findings of the cytomegalic cells were consistent with oncocytes. Previous reports in the literature of similar cells in the salivary glands of insectivores appear to have been erroneously described as cytomegalovirus infections.
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Serial CT findings in an infant with HTLV-III infection and cytomegalic inclusion virus encephalitis are presented.
In a randomised study the efficacy of a cytomegalic hyperimmune globulin preparation (CMV-HIGP) which had been treated with beta-propiolactone was analysed. The study included 85 patients with acute lymphoblastic leukemia (ALL) and Non-B-Non-Hodgkin-lymphoma (NHL) who were treated initially or underwent a relapse therapy. During the intense chemotherapeutical period within leukemia treatment the patients were passively immunised by the intravenous route with CMV-HIGP (1 ml per kilogram of body weight) every two to three weeks at the latest. In the initial stages the basic immunisation protection was achieved by the application of double dose CMV-HIGP. The Frankfurt patients were recruited from the BFM-ALL- and the NHL-study since october 1982. When they were admitted their CMV serostatus was determined by means of the ELA-ELISA or IFA-method. Seronegative patients were given the passive immunisation immediately or 48 hours after the first blood transfusions at the latest. The patients who had become CMV-IgG-positive by passive immunisation were randomised when reaching long-term therapy according to the protocol. Because of a 30% cytomegaly disease incidence rate in our patient population a randomisation was unwarrantable at the beginning of leukemia treatment. During randomisation one group of patients were immunised by the intravenous route with CMV-HIGP (2 ml per kg body weight one time in four weeks), the second group was a control group.(ABSTRACT TRUNCATED AT 250 WORDS)
We reported a 44 year old man with micronodular cirrhosis who eventually died from massive hematemesis and melena. At postmortem studies, there were disseminated cytomegalic inclusion bodies detected in various organs. In liver, intranuclear inclusion bodies were observed in cirrhotic liver. We discussed here possible pathogenesis of CMV (cytomegalovirus) infection in adults, in reviewing literatures.
Cytomegalovirus (CMV) infections acquire characteristics of special severity when they occur in patients suffering primary or secondary cellular immune depression. We present a case of pneumonia with fatal evolution caused by CMV, in a female patient suffering systemic lupus erythematosus. The underlying disease, of recent onset, presented multiorgan involvement (skin, joints, kidney, blood) which could be controlled with steroids and azathioprine. The patient presented a few days after she had overcome an acute outbreak of the disease, a febrile status with rapid evolution with a diffuse pulmonary interstitial infiltrate. Circulating anti CMV antibodies were detected, of IgM class, by a enzyme-immunoassay. The necropsy showed a multiorgan infiltrate (liver, lung, skin, kidney) with cells containing cytomegalic inclusion.
A case of cytomegalovirus-induced vasculitis led to skin ulcerations in a renal transplant patient. Light and electron microscopy revealed inclusion bodies and viral particles, respectively, characteristic of cytomegalovirus. To our knowledge, this is the first report of cytomegalovirus-induced vasculitis producing skin ulcerations, and it illustrates another of the protean manifestations of cytomegalovirus inclusion disease that may have important clinical implications.
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