Chapter 100 : Human Cytomegalovirus

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Cytomegalovirus (CMV) belongs to a large family of herpesviruses that commonly infect humans of all ages. Although infections with this virus are normally asymptomatic in healthy children and adults, CMV is one of the most notable viral pathogens causing serious diseases in newborns and individuals with compromised immune systems. This chapter emphasizes the fundamental characteristics and clinical importance of CMV and focuses on the laboratory tests that can be used to identify the virus and monitor and predict disease and susceptibility to antiviral therapy and the philosophy behind the interpretation and reporting of test results in various defined patient populations.

Citation: Hodinka R. 2015. Human Cytomegalovirus, p 1718-1737. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch100
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Image of FIGURE 1

Fixed hematoxylin and eosin-stained lung tissue from a patient with interstitial pneumonia. Note the numerous giant cells that possess large intranuclear inclusions surrounded by characteristically clear halos (arrows). Less pronounced granular inclusions may also be present in the cytoplasm (inset). (Courtesy of Eduardo Ruchelli.) doi:10.1128/9781555817381.ch100.f1

Citation: Hodinka R. 2015. Human Cytomegalovirus, p 1718-1737. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch100
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Image of FIGURE 2

CMV antigen-positive polymorphonuclear leukocytes. Note the nuclear staining when a monoclonal antibody directed against pp65 is used. Magnification, ×100 (A) or ×400 (B). doi:10.1128/9781555817381.ch100.f2

Citation: Hodinka R. 2015. Human Cytomegalovirus, p 1718-1737. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch100
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Image of FIGURE 3

CPE produced by a CMV isolate in human skin fibroblasts 10 days postinoculation. Unstained preparation; magnification, ×100. (Courtesy of Sergio Stagno.) doi:10.1128/9781555817381.ch100.f3

Citation: Hodinka R. 2015. Human Cytomegalovirus, p 1718-1737. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch100
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Image of FIGURE 4

Demonstration of CMV early antigens in the nuclei (arrows) of infected MRC-5 cells following shell vial culture and IFA staining. (A) Staining of immediate early antigen appears as an even matte yellow to green fluorescence with specks of brighter yellow to green. (B) Viral inclusions (owl’s eyes) may be visible in the nuclei. Magnification, ×400. doi:10.1128/9781555817381.ch100.f4

Citation: Hodinka R. 2015. Human Cytomegalovirus, p 1718-1737. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch100
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Available commercial CMV antigenemia assays

Citation: Hodinka R. 2015. Human Cytomegalovirus, p 1718-1737. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch100
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Selected commercial molecular assays available for qualitative and quantitative detection of CMV

Citation: Hodinka R. 2015. Human Cytomegalovirus, p 1718-1737. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch100
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Immunoassay systems for CMV IgG and IgM antibody detection

Citation: Hodinka R. 2015. Human Cytomegalovirus, p 1718-1737. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch100

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