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Chapter 4 : Cytomegalovirus

Authors: M. Veronica Dioverti1, Raymund R. Razonable2
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Affiliations: 1: Division of Infectious Diseases, Department of Medicine; 2: Division of Infectious Diseases, Department of Medicine; 3: The William J von Liebig Center for Transplantation and Clinical Regeneration, Mayo Clinic College of Medicine, Rochester, MN 55905
Content Type: Monograph
Publication Year: 2016

Category: Clinical Microbiology

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Cytomegalovirus, Page 1 of 2

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Abstract:

Cytomegalovirus (CMV), the fifth member of the human herpesvirus family, is one of the largest viruses known to cause clinical disease. It is a double-stranded DNA virus that belongs to the beta-herpesvirus subfamily, along with human herpesviruses 6A, 6B, and 7. CMV was first associated with an infectious mononucleosis-like illness in healthy individuals in 1965 ( ). Currently, it is known to cause a wide range of clinical syndromes, from asymptomatic infection in healthy hosts, to severe and even fatal disease in immunocompromised individuals, such as transplant recipients.

Citation: Dioverti M, Razonable R. 2016. Cytomegalovirus, p 97-125. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0022-2015
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Cytomegalovirus
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Citation: Dioverti M, Razonable R. 2016. Cytomegalovirus, p 97-125. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0022-2015
/content/10.1128/9781555819040.chap4.fig4-1
Figure 1

Cytomegalovirus-induced cytopathic effects. Unstained preparation; 100X magnification.

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Figure 1

Cytomegalovirus-induced cytopathic effects. Unstained preparation; 100X magnification.

Citation: Dioverti M, Razonable R. 2016. Cytomegalovirus, p 97-125. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0022-2015
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Figure 2

Detection of CMV antigens in the nucleic acid of infected MCR-5 cells. Following shell-vial culture, cells are stained with fluorescently-labeled antibodies which detect CMV immediate early antigen. Magnification 200X.

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Image of Figure 2
Figure 2

Detection of CMV antigens in the nucleic acid of infected MCR-5 cells. Following shell-vial culture, cells are stained with fluorescently-labeled antibodies which detect CMV immediate early antigen. Magnification 200X.

Citation: Dioverti M, Razonable R. 2016. Cytomegalovirus, p 97-125. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0022-2015
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Figure 3

This biopsy specimen from a patient with cytomegalovirus colitis shows a classic “owl-eye” intranuclear inclusion (arrow) and intracytoplasmic inclusions. The dense intranuclear inclusion with surrounding halo is formed when the mass of viral particles shrinks away from the nuclear membrane during fixation. While herpes simplex virus intranuclear inclusions can have a similar appearance, CMV is the only member of the herpesviridae family that contains both intranuclear and intracytoplasmic inclusions. Hematoxylin and eosin stain, 1000x oil immersion.

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Image of Figure 3
Figure 3

This biopsy specimen from a patient with cytomegalovirus colitis shows a classic “owl-eye” intranuclear inclusion (arrow) and intracytoplasmic inclusions. The dense intranuclear inclusion with surrounding halo is formed when the mass of viral particles shrinks away from the nuclear membrane during fixation. While herpes simplex virus intranuclear inclusions can have a similar appearance, CMV is the only member of the herpesviridae family that contains both intranuclear and intracytoplasmic inclusions. Hematoxylin and eosin stain, 1000x oil immersion.

Citation: Dioverti M, Razonable R. 2016. Cytomegalovirus, p 97-125. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0022-2015
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Figure 4

Immunoperoxidase staining of CMV antigens in a biopsy from a patient with CMV colitis. Viral inclusions stain brown (blue counterstain, 1000x oil immersion).

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Image of Figure 4
Figure 4

Immunoperoxidase staining of CMV antigens in a biopsy from a patient with CMV colitis. Viral inclusions stain brown (blue counterstain, 1000x oil immersion).

Citation: Dioverti M, Razonable R. 2016. Cytomegalovirus, p 97-125. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0022-2015
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Figure 5

Diagnostic algorithm for transplant recipients and their donors with the use of CMV serology.

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Figure 5

Diagnostic algorithm for transplant recipients and their donors with the use of CMV serology.

Citation: Dioverti M, Razonable R. 2016. Cytomegalovirus, p 97-125. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0022-2015
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Figure 6

An illustrative algorithm utilizing various diagnostic assays in a transplant recipient prior to transplantation and during the period following transplantation.

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Image of Figure 6
Figure 6

An illustrative algorithm utilizing various diagnostic assays in a transplant recipient prior to transplantation and during the period following transplantation.

Citation: Dioverti M, Razonable R. 2016. Cytomegalovirus, p 97-125. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0022-2015
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Figure 7

Algorithm for the diagnosis of CMV disease in an immunocompromised patient.

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Image of Figure 7
Figure 7

Algorithm for the diagnosis of CMV disease in an immunocompromised patient.

Citation: Dioverti M, Razonable R. 2016. Cytomegalovirus, p 97-125. In Hayden R, Wolk D, Carroll K, Tang Y (ed),

Diagnostic Microbiology of the Immunocompromised Host, Second Edition

. ASM Press, Washington, DC. doi: 10.1128/microbiolspec.DMIH2-0022-2015
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Tables

Cytomegalovirus
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