Cytomegalovirus infection of the CNS in non-compromised patients.
Six non-compromised patients with cytomegalovirus (CMV) associated meningoencephalitis are described. CMV was isolated from the cerebrospinal fluid (CSF) in 2/4 cases, while the diagnosis was based on an 8-fold rise in CMV-specific serum IgG antibodies and intrathecal antibody production against CMV in one case. By the polymerase chain reaction (PCR) CMV DNA was detected in the CSF in 5/5 cases and in serum in 3/4 cases. In one patient who had an Influenza A infection, both CMV and Epstein-Barr virus DNA were detected by PCR in the CSF. In 4 patients possible triggering events could be identified. Symptoms and signs indicating a multifocal brain involvement were present in 4 patients. The outcome was generally favourable except for sequelae in form of slight dysphasia in one case.
Department of Infectious Diseases, University of Gothenburg, Sweden.
M
M
Studahl
A
A
Ricksten
T
T
Sandberg
S
S
Elowson
S
S
Herner
C
C
Säll
T
T
Bergström
D000368:Aged; D001921:Brain / Q000821:virology; D002555:Cerebrospinal Fluid / Q000821:virology; D003587:Cytomegalovirus / Q000302:isolation & purification* / Q000472:pathogenicity*; D004279:DNA, Viral; D005260:Female; D004854:Herpesvirus 4, Human / Q000302:isolation & purification* / Q000472:pathogenicity*; D006801:Humans; D007074:Immunoglobulin G / Q000134:cerebrospinal fluid; D007075:Immunoglobulin M / Q000134:cerebrospinal fluid; D008297:Male; D008590:Meningoencephalitis / Q000209:etiology* / Q000821:virology*; D016133:Polymerase Chain Reaction
D004279:DNA, Viral; D007074:Immunoglobulin G; D007075:Immunoglobulin M