Clinical, serological and PCR evidence of cytomegalovirus infection in the central nervous system in infancy and childhood.

• Over a 3-year-period (Dec. 1990-Nov. 1993) 12 children were found PCR-positive for CMV-DNA in CSF and brain biopsies. Three of the patients were immunologically compromised. During the same period CSF samples from 10 shunt-operated children and 143 virological routine CSF samples were PCR CMV negative. Clinical association with positive PCR-CMV reaction was considered likely in 6 patients: two boys developed prolonged fever and meningoencephalitis following neurosurgery, one infant girl had a course compatible with congenital inclusion disease, and three had prolonged fever following transplantation. Clinical association was deemed probable in 3 infant girls: one had neonatal infection, meningitis and intraventricular haemorrhage, one had neonatal encephalitis and failure to thrive, and one with neonatal seizures and encephalitis developed brain atrophy. Clinical association was judged possible in 3 patients: one infant girl with no signs of encephalitis developed brain atrophy, one had an Aicardi Type 1 syndrome and one 2 1/2-year-old boy had an acute encephalitis with insufficient serological support for CMV but was 12 months later PCR positive for CMV. We conclude that CMV may be an overlooked infectious agent of the CNS also in immunocompetent children. PCR aids in rapid diagnosis of CMV infection in the immunocompromised. CMV may occasionally be disclosed with PCR in other conditions as a probably non-relevant observation.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Pediatrik (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Pediatrics (hsv//eng)

Nyckelord

Brain

immunology

physiopathology

virology

Cerebrospinal Fluid

immunology

Child

Child

Preschool

Cytomegalovirus

immunology

isolation & purification

Cytomegalovirus Infections

complications

immunology

virology

DNA

Viral

Enzyme-Linked Immunosorbent Assay

Epilepsy

etiology

physiopathology

Failure to Thrive

etiology

Female

Humans

Immunoglobulin G

blood

Infant

Infant

Newborn

Leukomalacia

Periventricular

etiology

physiopathology

Male

Polymerase Chain Reaction

Psychomotor Disorders

etiology

physiopathology

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)