Cytomegalovirus myocarditis in a heart transplant recipient: sensitive monitoring of viral DNA by the polymerase chain reaction.
A 54-year-old female heart transplant recipient had an acute episode of graft rejection that was treated with high-dose immunosuppression therapy. During this therapy a second febrile illness developed, which was accompanied by hypotension, anemia, and rash. Findings for subsequent myocardial biopsy specimens were negative for cytomegalovirus by culture but were strongly positive for cytomegalovirus deoxyribonucleic acid by the polymerase chain reaction. Histologic observation of viral inclusions in the myocardial fibers supported the diagnosis of cytomegalovirus myocarditis. The polymerase chain reaction therefore can provide a rapid and highly sensitive method for heart transplant patients with suspected cytomegalovirus myocarditis.
Powell
K F
KF
Department of Cellular and Molecular Biology, University of Auckland, New Zealand.
Bellamy
A R
AR
Catton
M G
MG
Cooper
I P
IP
Philip
B A
BA
Rainer
S P
SP
Coverdale
H A
HA
Croxson
M C
MC
D003587:Cytomegalovirus / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D004279:DNA, Viral / Q000302:isolation & purification; D005260:Female; D006084:Graft Rejection; D016027:Heart Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008875:Middle Aged; D009205:Myocarditis / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology; D016133:Polymerase Chain Reaction; D014773:Virology / Q000379:methods
D004279:DNA, Viral; D007166:Immunosuppressive Agents