title: The utility of clinical and radiographic features in the diagnosis of cytomegalovirus central nervous system disease in AIDS patients.
abstract: BACKGROUND
  Polymerase chain reaction (PCR) assays of cerebrospinal fluid (CSF) for cytomegalovirus (CMV) DNA have facilitated the diagnosis of CMV-associated central nervous system disease in AIDS patients. We attempt to correlate clinical and radiographic features that are associated with CMV PCR- positivity in CSF from AIDS patients with neurologic disease.
  
  
  RESULTS
  A retrospective case controlled comparison was made of CMV PCR-positive and PCR-negative patients.
  
  
  RESULTS
  CMV PCR-positive patients were significantly more likely to have nystagmus, prior CMV retinitis, and CSF protein levels.90 mg/dL. Of patients with 0, 1, and $2 of these features, 5.6%, 55.2%, and 88.9%, respectively, were PCR-positive. Ependymal enhancement was present by magnetic resonance imaging in 9 of 12 PCR-positive, and in 8 of 30 PCR-negative patients.
  
  
  CONCLUSIONS
  These clinical and radiographic features may serve as useful adjuncts toward the establishment of the diagnosis of CMV-associated neurologic disease in AIDS patients.
authors.affiliation: Departments of Medicine, Pathology and Radiology, University Hospitals of Cleveland, MetroHealth Medical Center, Cleveland, OH 44109-1998, USA.
authors.forename: D G
authors.initials: DG
authors.lastname: Burke
authors.forename: D G
authors.initials: DG
authors.lastname: Leonard
authors.forename: T F
authors.initials: TF
authors.lastname: Imperiale
authors.forename: H
authors.initials: H
authors.lastname: Valdez
authors.forename: B
authors.initials: B
authors.lastname: Karaman
authors.forename: E
authors.initials: E
authors.lastname: Shick
authors.forename: R C
authors.initials: RC
authors.lastname: Kalayjian
mesh_terms: D017088:AIDS-Related Opportunistic Infections / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D000328:Adult; D016022:Case-Control Studies; D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D017726:Cytomegalovirus Retinitis / Q000150:complications / Q000175:diagnosis; D004279:DNA, Viral / Q000134:cerebrospinal fluid; D018792:Encephalitis, Viral / Q000175:diagnosis* / Q000473:pathology / Q000821:virology; D004805:Ependyma / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009187:Myelitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000821:virology; D009759:Nystagmus, Pathologic / Q000175:diagnosis / Q000209:etiology; D016133:Polymerase Chain Reaction; D011237:Predictive Value of Tests; D011843:Radiculopathy / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000821:virology; D011859:Radiography; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D016037:Single-Blind Method
chemical_list: D004279:DNA, Viral