Abstract
The distribution of infected cells in 13 necropsies on adults with cytomegalovirus disease is reported and discussed in relation to the local damage caused by the infection and predisposing factors.
The distribution, with lung as the most common site, but other organs such as thyroid, liver, and colon not infrequently involved, agrees fairly well with other series. No heavy infection confined to one organ was found, and it is concluded that a truly localized infection in the adult probably does not occur.
Evidence of destructive inflammatory changes attributable to the virus was scanty; a lymphocyte and plasma cell infiltrate was sometimes found, and microglial nodules were found in a case with inclusions in the brain. In one case heavy cytomegalovirus infection in the colon was associated with, and probably caused, marked colonic ulceration which led to the death of the patient.
The major predisposing factor to infection in this series was corticosteroid therapy: eight of the 13 patients had been treated with steroids and one had Cushing's syndrome associated with a bronchial carcinoma. Three of the other four patients had a very few inclusions only. Adrenal involvement was not found in any of the steroid-treated patients but was present in two of the four patients not treated with steroids where adrenal sections were available.
It is concluded that most adult patients with cytomegalovirus infection have impaired immune mechanisms, and that heavy infection may rarely lead to a clinically serious disease.
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- BECKER F. P., EDDY J. R. AUTOIMMUNE HEMOLYTIC ANEMIA WITH TERMINAL LYMPHOMA AND CYTOMEGALIC INCLUSION DISEASE. N Y State J Med. 1964 May 15;64:1211–1212. [PubMed] [Google Scholar]
- BODEY G. P., WERTLAKE P. T., DOUGLAS G., LEVIN R. H. CYTOMEGALIC INCLUSION DISEASE IN PATIENTS WITH ACUTE LEUKEMIA. Ann Intern Med. 1965 May;62:899–906. doi: 10.7326/0003-4819-62-5-899. [DOI] [PubMed] [Google Scholar]
- BUNAREVIC A., URBANKE A. [Cytomegaly in adults]. Acta Med Iugosl. 1961;15:227–239. [PubMed] [Google Scholar]
- CAZAL P., MIROUZE J., PAGES A., JAFFIOL C., GINIER C. [An unusual form of diabetes in the adult: cytomegalic disease with duodenopancreatic inclusion]. Sem Hop. 1963 May 26;39:1294–1298. [PubMed] [Google Scholar]
- DEMPSTER W. J., HARRISON C. V., SHACKMAN R. REJECTION PROCESSES IN HUMAN HOMOTRANSPLANTED KIDNEYS. Br Med J. 1964 Oct 17;2(5415):969–976. doi: 10.1136/bmj.2.5415.969. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Duvall C. P., Casazza A. R., Grimley P. M., Carbone P. P., Rowe W. P. Recovery of cytomegalovirus from adults with neoplastic disease. Ann Intern Med. 1966 Mar;64(3):531–541. doi: 10.7326/0003-4819-64-3-531. [DOI] [PubMed] [Google Scholar]
- HANSHAW J. B. CLINICAL SIGNIFICANCE OF CYTOMEGALOVIRUS INFECTION. Postgrad Med. 1964 May;35:472–480. doi: 10.1080/00325481.1964.11695114. [DOI] [PubMed] [Google Scholar]
- HEARD B. E., HASSANAM, WILSON S. M. Pulmonary cytomegalic inclusion-body disease in a diabetic. J Clin Pathol. 1962 Jan;15:17–20. doi: 10.1136/jcp.15.1.17. [DOI] [PMC free article] [PubMed] [Google Scholar]
- HEDLEY-WHYTE E. T., CRAIGHEAD J. E. REPORT OF A CASE WITH ISOLATION OF VIRUS. N Engl J Med. 1965 Mar 4;272:473–475. doi: 10.1056/NEJM196503042720907. [DOI] [PubMed] [Google Scholar]
- JACOX R. F., MONGAN E. S., HANSHAW J. B., LEDDY J. P. HYPOGAMMAGLOBULINEMIA WITH THYMOMA AND PROBABLE PULMONARY INFECTION WITH CYTOMEGALOVIRUS. N Engl J Med. 1964 Nov 19;271:1091–1096. doi: 10.1056/NEJM196411192712104. [DOI] [PubMed] [Google Scholar]
- Kanich R. E., Craighead J. E. Cytomegalovirus infection and cytomegalic inclusion disease in renal homotransplant recipients. Am J Med. 1966 Jun;40(6):874–882. doi: 10.1016/0002-9343(66)90202-6. [DOI] [PubMed] [Google Scholar]
- Käriäinen L., Klemola E., Paloheimo J. Rise of cytomegalovirus antibodies in an infectious-mononucleosis-like syndrome after transfusion. Br Med J. 1966 May 21;1(5498):1270–1272. doi: 10.1136/bmj.1.5498.1270. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Lamb S. G., Stern H. Cytomegalovirus mononucleosis with jaundice as presenting sign. Lancet. 1966 Nov 5;2(7471):1003–1006. doi: 10.1016/s0140-6736(66)92929-1. [DOI] [PubMed] [Google Scholar]
- MEDEARIS D. N., Jr OBSERVATIONS CONCERNING HUMAN CYTOMEGALOVIRUS INFECTION AND DISEASE. Bull Johns Hopkins Hosp. 1964 Mar;114:181–211. [PubMed] [Google Scholar]
- Martin A. M., Jr, Kurtz S. M. Cytomegalic inclusion disease. An electron microscopic histochemical study of the virus at necropsy. Arch Pathol. 1966 Jul;82(1):27–34. [PubMed] [Google Scholar]
- Rifkind D. Cytomegalovirus infection after renal transplantation. Arch Intern Med. 1965 Oct;116(4):554–558. [PubMed] [Google Scholar]
- Rose M. S. Hodgkin's granuloma complicated by generalized cytomegalic inclusion disease and gastrointestinal moniliasis. J Clin Pathol. 1966 May;19(3):266–267. doi: 10.1136/jcp.19.3.266. [DOI] [PMC free article] [PubMed] [Google Scholar]
- SCATTINI C. M., CAMPOS C. A., BUR G. E. NEUMONITIS POR ADENOVIRUS CON INCLUSIONES CITOMEG'ALICAS ASOCIADA A HEPATITIS SUBAGUDA Y TUBERCULOSIS. Prensa Med Argent. 1963 May 17;50:1217–1222. [PubMed] [Google Scholar]
- SIGNER E. [Cytomegaly in an adult]. Pathol Microbiol (Basel) 1962;25:359–362. [PubMed] [Google Scholar]
- STERN H. OPPORTUNISTIC INFECTIONS. HUMAN CYTOMEGALOVIRUS INFECTION. Proc R Soc Med. 1965 May;58:346–349. [PMC free article] [PubMed] [Google Scholar]
- WHEELER C. E., CANBY C. M. Influence of specific antibody on herpes simplex infections in tissue culture. AMA Arch Derm. 1959 Jan;79(1):86–95. doi: 10.1001/archderm.1959.01560130088010. [DOI] [PubMed] [Google Scholar]
- WONG T. W., WARNER N. E. Cytomegalic inclusion disease in adults. Report of 14 cases with review of literature. Arch Pathol. 1962 Nov;74:403–422. [PubMed] [Google Scholar]