Primer-mediated enzymatic amplification of cytomegalovirus (CMV) DNA. Application to the early diagnosis of CMV infection in marrow transplant recipients.

Cassol, Sharon; Poon, M C; Pal, Ranajit; Naylor, Matthew J.; Culver-James, J; Bowen, Tom; Russell, Joanne; Krawetz, Stephen A.; Pon, Richard T.; Hoar, DI

doi:10.1172/jci113990

Cited by 100 publications

(36 citation statements)

References 32 publications

(25 reference statements)

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“…?~ In an effort to overcome these deficiencies we have used a molecular biological approach to detect the parasite's DNA in infected tissues. Similar approaches have been used to detect several bacterial,8i l 1 viral12* [14][15][16] and protozoang. l o parasites.…”

Section: Discussionmentioning

confidence: 99%

Polymerase chain reaction for detection of Toxoplasma gondii

Savva

Morris

Johnson

et al. 1990

Journal of Medical Microbiology

120

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Section: Discussionmentioning

confidence: 99%

Polymerase chain reaction for detection of Toxoplasma gondii

Savva

Morris

Johnson

et al. 1990

Journal of Medical Microbiology

120

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“…While in three reports viral DNA was found in virtually all seropositive healthy adult volunteers and in most seronegative persons when monocytes (268,273) or peripheral blood leukocytes (14) were examined, other investigators failed to detect viral DNA by PCR in monocytes (16) or peripheral blood leukocytes (78,135,229,240) or reported low (4 to 6%) positivity rates (34,249). Recent studies support the concept that viral DNA is not detected in the peripheral blood leukocytes of HCMV-seropositive immunocompetent individuals (216,294), emphasizing the utility of viral DNA detection in blood as a parameter for diagnosing primary HCMV infection.…”

Section: Detection Of Virus and Viral Products In Maternal Bloodmentioning

confidence: 97%

Diagnosis and Management of Human Cytomegalovirus Infection in the Mother, Fetus, and Newborn Infant

2002

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Human cytomegalovirus (HCMV) is the leading cause of congenital viral infection and mental retardation. HCMV infection, while causing asymptomatic infections in most immunocompetent subjects, can be transmitted during pregnancy from the mother with primary (and also recurrent) infection to the fetus. Hence, careful diagnosis of primary infection is required in the pregnant woman based on the most sensitive serologic assays (immunoglobulin M [IgM] and IgG avidity assays) and conventional virologic and molecular procedures for virus detection in blood. Maternal prognostic markers of fetal infection are still under investigation. If primary infection is diagnosed in a timely manner, prenatal diagnosis can be offered, including the search for virus and virus components in fetal blood and amniotic fluid, with fetal prognostic markers of HCMV disease still to be defined. However, the final step for definite diagnosis of congenital HCMV infection is detection of virus in the blood or urine in the first 1 to 2 weeks of life. To date, treatment of congenital infection with antiviral drugs is only palliative both prior to and after birth, whereas the only efficacious preventive measure seems to be the development of a safe and immunogenic vaccine, including recombinant, subunit, DNA, and peptide-based vaccines now under investigation. The following controversial issues are discussed in the light of the most recent advances in the field: the actual perception of the problem; universal serologic screening before pregnancy; the impact of correct counseling on decision making by the couple involved; the role of prenatal diagnosis in ascertaining transmission of virus to the fetus; the impact of preconceptional and periconceptional infections on the prevalence of congenital infection; and the prevalence of congenitally infected babies born to mothers who were immune prior to pregnancy compared to the number born to mothers undergoing primary infection during pregnancy

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“…The recent development of the polymerase chain reaction technique has allowed isolation of CMV based on the presence of DNA from this organism within CSF [7]. This technique is positive for the presence of an organism evenwhencultureshavenegativefindingsand can obviate biopsy in many instances.…”

Section: Discussionmentioning

confidence: 99%

Cytomegalovirus encephalomyelitis: MR imaging findings documenting response to ganciclovir therapy.

Arata¹,

Provenzale²,

Vredenburgh³

1998

American Journal of Roentgenology

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A CNS infection due to cytomega lovirus (CMV) is typically seenin individualswith AIDS and is un common in individuals who are immunosup pressed for other reasons. In general, brain infection by CMV is more common than spinal infection, and the latter is usually manifested by spinal nerve root involvement (i.e., polyradicu litis) [1]. We report the MR imaging findings in an immunosuppressed patient without AIDS in whom clinical and imaging findings were located predominantly in the spinal cord rather than in the brain or spinal nerve roots.The imaging findings of CMV encephalo myelitis are important to recognize because early specific therapy may be life-saving. Case ReportA left breastmasswasfoundat mammogra phy in a 51-year-old woman and was diag nosed as carcinoma by needle biopsy. She underwent left mastectomy and axillary node dissection, which showed multiple lymph nodes positive for the presence of carcinoma. She was treated with a regimen of cyclophos phamide,methotrexate,and 5-fluorouracil. Six years later she developed a left chest wall mass. Fine-needle biopsy showed metastatic breast carcinoma, and she was treated with doxorubicin for 3 months, with a marked de crease in the size of the mass, followed by treatment with cisplatin, carmustine, and cy clophosphamide with stem-cell rescue. Two weeks after completion of chemotherapy, she began to experience leg paresthesias that were initially thought to represent effects of chemo therapy. The paresthesias slowly progressed over the next 6 weeks, consistent with cisplatin sensory polyneuropathy. However, over the course of 1 week, rapidly progressive leg anes thesia, paraparesis,and urinary incontinence developed.Lumbar punctureand MR imaging findings of the brain and total spine 2 days af ter rapid onset of clinical deterioration were negative. The patient was then transferred to our institution for further examination.A secondMR imaging study on hospital day I (7 days after the initial MR imaging study) revealed multiple sites of hyperintense signal on T2-weighted images involving the cervical spinal cord and medulla (Fig. lÃ€).On unenhanced TI-weighted images, the lesions appeared hypointense. After contrast adminis tration, the cervical spine lesions showed ring like enhancement,whereas those within the medulla showed nodular enhancement (Fig. lB). MR imaging of the brain did not reveal other lesions. Because of the possibility that the lesionsrepresentedintramedullary metastases, 18F-fluorodeoxyglucose positron emission to mography was performed on hospital day 8. No increasedmetabolic activity was seenwithin the lesions, and this finding was inter preted as evidence against metastasis. On the assumptionthat the myelopathy could be due to an inflammatoiy demyelinating process, corticosteroid therapy was started on hospital day 3. Follow-up MR imaging on hospital day 9 showed an increase in the size and contrast enhancement of the lesion. A sample of CSF from a secondlumbar punctureon hospital day 13 had positive findings for CMV as deter mined by p...

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Primer-mediated enzymatic amplification of cytomegalovirus (CMV) DNA. Application to the early diagnosis of CMV infection in marrow transplant recipients.

Cited by 100 publications

References 32 publications

Polymerase chain reaction for detection of Toxoplasma gondii

Polymerase chain reaction for detection of Toxoplasma gondii

Diagnosis and Management of Human Cytomegalovirus Infection in the Mother, Fetus, and Newborn Infant

Cytomegalovirus encephalomyelitis: MR imaging findings documenting response to ganciclovir therapy.

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