Table 1.
Characteristics of diagnostic tests for CMV colitis
| Diagnostic test | Pros | Cons |
|---|---|---|
| CMV IgG | Verifies prior exposure to CMV | Uncorrelated with CMV colitis |
| Distinguishes patients with risk for CMV colitis | ||
| CMV IgM | Verifies acute infection or reactivation accompanied by viremia | Presents systemic disease |
| Antigenemia assay | Relatively high specificity for the diagnosis of CMV colitis | Relatively low sensitivity for the diagnosis of CMV colitis |
| Takes a short time to obtain results (24 hour) | ||
| Helpful for predicting clinical course of CMV colitis | ||
| Blood CMV DNA PCR | Noninvasive; endoscopy is not required | Requires a cut-off value for the diagnosis of CMV colitis |
| Histological H&E staining | High specificity for the diagnosis of CMV colitis | Low sensitivity for CMV colitis Requires many tissue samples and skilled pathologist |
| Histological IHC staining | Higher sensitivity than H&E for the diagnosis of CMV colitis | Takes a long time to obtain results (3-5 days) |
| Tissue CMV DNA PCR | Very high sensitivity for CMV detection in colon | Clinical meaning of positivity is unclear |
| Endoscopy | High sensitivity for the diagnosis of CMV colitis | Low specificity for the diagnosis of CMV colitis |
| Culture | High sensitivity and specificity for the diagnosis of CMV colitis | Takes a long time to obtain results (2-4 weeks) |
CMV, cytomegalovirus; IgG, immunoglobulin G; IgM, immunoglobulin M; PCR, polymerase chain reaction; IHC, immunohistochemistry.