Congenital Cytomegalovirus Infection and Maternal Varicella during Pregnancy.Is There a Coincidence?A Case Report

Background: Co-infections may represent substantial diagnostic and treatment challenges. Aim: To the better of our knowledge, we describe the first case in the literature of congenital Cytomegalovirus (CMV) infection following maternal CMV non primary infection contemporary to varicella during pregnancy. Case Presentation: A pregnant woman had a varicella during her pregnancy. Congenital CMV infection was fortuitously discovered in the neonate owing to a universal CMV screening. Retrospective analysis of maternal serums during pregnancy showed CMV reactivation. We aim to highlight that CMV reactivation could be due to varicella and discuss if it could facilitate the transplacental transmission of CMV. Conclusion: This case report emphasizes neonatal CMV screening, and warns against dual maternal infection especially because this may be at particular risk of transmission to the fetus.

Management strategies for common viral infections in pediatric renal transplant recipients

Viral infections have been considered as a major cause of morbidity and mortality after kidney transplantation in pediatric cohort.Children are at high risk of acquiring virus-related complications due to immunological immaturity and the enhanced alloreactivity risk that led to maintenance of high immunosuppressive regimes.Hence,prevention,early detection,and prompt treatment of such infections are of paramount importance.Among all viral infections,herpes viruses(herpes simplex virus,varicella zoster virus,Epstein-Barr virus,cytomegalovirus),hepatitis B and C viruses,BK polyomavirus,and respiratory viruses(respiratory syncytial virus,parainfluenza virus,influenza virus and adenovirus)are common in kidney transplant recipients.These viruses can cause systemic disease or allograft dysfunction affecting the clinical outcome.Recent advances in technology and antiviral therapy have improved management strategies in screening,monitoring,adoption of prophylactic or preemptive therapy and precise treatment in the immunocompromised host,with significant impact on the outcome.This review discusses the etiology,screening and monitoring,diagnosis,prevention,and treatment of common viral infections in pediatric renal transplant recipients.

A Study on the Traditional Chinese Medicine Jinyebaidu for Prevention and Treatment of Intrauterine Infection with Guinea Pigs Cytomegalovirus

The purpose is to study the prophylactic and therapeutic effect of the traditional Chinese Medicine （TCM）-Jinyebaidu （JYBD） to guinea pig cytomegalovirus （GPCMV） intrauterine infection. The virus-free female and male guinea pigs were screened with nest-polymerase chain reaction （N-PCR）. After inbred, pregnant guinea pigs were selected and divided into 3 groups randomly： 5 guniea pigs of the blank control group were not given either GPCMV or JYBD. 31 guniea pigs of the positive control group were inoculated 1 mL （107 TCID50 ） suspension of GPCMV intraperitoneal. 10 gunlea pigs of the experimental group were inoculated GPCMV firstly and then perfused stomach with JYBD for 14 days （Dosage in accordance with the modulus of the weight ratio of human to guniea pig）. The effects of JYBD on the intrauterine infection of GPCMV were observed. The results showed that JYBD could decrease the maternal infection rate from 100 % （31/31） to 50 % （5/10） （P〈0. 001）, the intrauterine infection rate from 100% （72/72） to 75 % （21/28） （P〈 0. 001）, and the rate of abnormal outcome of pregnancy from 64.4 % （29/45） to 25.0 % （7/28） （P〈0. 001）, the infective symptoms being relieved. It can be concluded that traditional Chinese medicine- JYBD can prevent and treat GPCMV intrauterine infection, and can be expected a prophylactic drug for HCMV intrauterine infection.

Cytomegalovirus infection in the bone marrow transplant patient

Cytomegalovirus(CMV) infection is an important contributor to the morbidity and mortality associated with bone marrow transplantation(BMT). Infection may lead to CMV disease involving multiple organs such as pneumonia, gastroenteritis, retinitis, central nervus system involvement and others. CMV seropositivity is an important risk factor and approximately half of BMT recipients will develop clinically significant infection most commonly in the first 100 d post-transplant. The commonly used tests to diagnose CMV infection in these patients include the pp65 antigenemia test and the CMV DNA polymerase chain reaction(PCR) assay. Because of its greater sensitivity and lesser turnaround time, the CMV PCR is nowadays the preferred test and serves as a main guide for pre-emptive therapy. Methods of CMV prevention include use of blood products from seronegative donors or leukodepleted products. Prophylaxis or pre-emptive therapy strategies for CMV prevention may be used post-transplant with the latter becoming more common. The commonly used antivirals for pre-emptive therapy and CMV disease management include intravenous gancyclovir and foscarnet. The role of intravenous immunoglobulin, although used commonly in CMV pneumonia is not clear.

Cytomegalovirus infection in liver-transplanted children

Cytomegalovirus (CMV) infection is a common complication of liver transplantationin children. The CMV serostatus of recipients and donors is theprimary risk factor, and prophylaxis or pre-emptive strategies are recommendedfor high-risk patients. Graft rejection, coinfection and Epstein-Bar virusreactivation, which can lead to post-transplant lymphoproliferative disease, areindirect effects of CMV infection. Assessment of CMV infection viral load shouldbe routinely performed upon clinical suspicion. However, tissue-invasive CMVdisease is not associated with CMV viraemia and requires confirmation by tissuepathology. Oral valganciclovir and intravenous ganciclovir are equivalenttreatments, and the duration of treatment depends on factors including CMV viralload, tissue pathology, and clinical response. Risk stratification by donor andrecipient status prior to transplantation and post-transplantation antiviralprophylaxis or pre-emptive therapy are recommended. Adult guidelines havebeen established but additional study of the effectiveness of the preventiveguidelines in children is needed. This review summarizes the burden, risk factors,clinical manifestations, laboratory evaluation, treatment, and prevention of CMVinfection in children after liver transplantation.

Murine brain tissues with human cytomegalovirus infection: a proteomic study

To establish two-dimensional electrophoresis profiles with high resolution and reproducibility from murine brain tissues by human cytomegalovirus（HCMV） infection and paired murine brain tissues and to identify the differential expression proteins. Methods： Forty Kunming mice were randomly divided into infection group （20） injected with HCMVAD169 and control group （20） injected with saline into their brain. After 30 days, the murine brain tissues by HCMV infection and paired murine brain tissues were separated by two-dimensional gel electrophoresis（2-DE）, analyzed by Image Master 2D software, and identified by peptide mass fingerprint（PMF） and database searching, and make Western blotting analyses the differential expression of individual proteins. Results： Well resolved, reproducible 2-D maps of the above tissues were obtained. Some of the different proteins identified by mass spectrometry（MS） were matched in the SWISS-2D PAGE database, Western blotting analyses were further carried out to verify the differential expression of individual proteins. Conclusion： These data will be valuable for studying the diagnosis of disease at an early stage, mechanisms of pathogenic and the key to the development of anti-HCMV medicine.

Impact of cytomegalovirus infection on biliary disease after liver transplantation-maybe an essential factor

BACKGROUND Cytomegalovirus(CMV)infection is common in liver transplant(LT)_recipients,and biliary complications occur in a large number of patients.It has been reported that CMV-DNA is more detectable in bile than in blood.AIM To investigate the effects of CMV infection on biliary complications by comparing the levels of CMV-DNA in the bile and blood of patients after LT.METHODS We conducted a retrospective analysis of 57 patients who underwent LT,10 of these patients had no biliary complications and 47 patients had biliary complications.We also compared the levels of CMV-DNA in patients’bile and blood,which were sampled concurrently.We used RNAscope technology to identify CMV in paraffin-embedded liver sections.RESULTS CMV-DNA was not detected in bile samples and was detected in 2 blood samples from patients without biliary complications.In the 47 patients with biliary complications,CMV-DNA was detected in 22 bile samples and 8 blood samples,both bile and blood samples were positive for CMV-DNA in 6 patients.The identification rate of CMV-DNA in blood was 17.0%,and was 46.8%in bile.Moreover,tissue samples from 4 patients with biliary complications tested positive using RNAscope technology but were negative with hematoxylin and eosin staining.During the follow-up period,graft failure occurred in 13 patients with biliary complications,8 of whom underwent retransplantation,and 3 died.CMV-DNA in bile was detected in 9 of 13 patients with graft failure.CONCLUSION In patients with biliary complications,the identification rate of CMV-DNA in bile was higher than that in blood.Blood CMV-DNA negative patients with biliary complications should still be monitored for CMV-related biliary tract diseases.Potential occult CMV infection may also be a contributing etiological factor in the development of graft failure.

Pneumococcal infection transmission between family members with congenital asplenia: A case report

BACKGROUND Asplenia,the lack of a spleen,can be congenital and increases susceptibility to severe infections caused by encapsulated bacteria,such as Streptococcus pneumoniae(S.pneumoniae).We report two cases of severe pneumococcal infection in two asplenic family members living in the same household.CASE SUMMARY Patient 1,a 38-year-old man with a history of congenital hepatitis B infection and hypospadias,was brought to our emergency department with complaints of cyanosis,cough,and edema of his limbs.He was clinically diagnosed as hyposplenic with overwhelming pneumococcal sepsis.He was admitted to the intensive care unit and was administered antibiotics and catecholaminergic therapy but died 2 h after admission.Patient 2,a 63-year-old woman with a history of type 2 diabetes,was brought to our emergency department one month after admission of Patient 1.She was diagnosed as asplenic with overwhelming pneumococcal sepsis.History-taking revealed that she was the mother of Patient 1 and the two had lived in the same household.She was admitted to the intensive care unit and was rapidly provided antibiotics and catecholaminergic intervention but died one day after admission.CONCLUSION Pneumococcal bacteremia caused by virulent S.pneumoniae may be transmitted within households.All residents of households where individuals with pneumococcal bacteremia are living should be educated about the risk of transmissibility.Family members of patients with congenital asplenia/hyposplenia,all family members should be examined to assess their splenic function.

An Evaluation of the Benefit of Cytomegalovirus Prophylaxis with Acyclovir on Post-Transplant Cytomegalovirus Infection Prevention in a Population of Renal Transplant Recipients in Nigeria

Background: Cytomegalovirus (CMV) is an important infection in renal transplant recipients and may significantly impact recipients’ long-term outcome and graft survival. Objective: This study aimed to evaluate the benefit of prophylaxis with acyclovir on post-transplant CMV infection prevention in a population of renal transplant recipients in Lagos, Nigeria. Subjects and Methods: The study was a cross-sectional design involving renal transplant recipients attending post-transplant follow-up clinics in Lagos, Nigeria between October 2004 and July 2005. Data on the use of CMV prophylaxis were obtained from the hospital case records of the study subjects. Enzyme-Linked Immunosorbent Assay (ELISA) was employed to detect CMV IgM antibodies for the diagnosis of post-transplant CMV infection and Microsoft Excel and EPI-Info 2002 statistical software were used for data entry and analysis. Results: Forty (40) renal transplant recipients were studied, 32 recipients were males and 8 were females with M:F ratio of 4:1. The mean age of the recipients was 39 ± 11.6 years old. The recipients’ post-transplant duration ranged from 2 to 80 months (Mean 17.6 ± 18.6 months). Fifteen (37.5%) of the transplant recipients received acyclovir prophylaxis for six months, one recipient (2.5%) received ganciclovir prophylaxis for three weeks while 24 recipients (60%) received no prophylactic therapy. There was no significant difference in the prevalence of seropositive CMV-IgM between transplant recipients who used CMV prophylaxis and those who did not (Fisher exact p = 0.45). Conclusion: Prophylaxis with acyclovir for six months showed no significant benefit on post-transplant CMV infection prevention in renal transplant recipients.

Awareness of Cytomegalovirus Infection among a Population of Nigerian Kidney Transplant Recipients

Background: Cytomegalovirus (CMV) is the most important infection in kidney transplant recipients and has significant impact on long term recipient and graft survival. Objective: The aim of this study is to assess the level of awareness of CMV infection among a population of kidney transplant recipients in Lagos, Nigeria. Subjects and Methods: The assessment of the level of awareness of CMV infection among kidney transplant recipients attending post-transplant follow-up clinics in Lagos, Nigeria was done by means of a structured pre-tested self-administered questionnaire from October 2004 to July 2005. Results: A total of 40 kidney transplant recipients were studied. Thirty-two recipients were males and eight were females with M:F ratio of 4:1. The mean age of the recipients was 39 ± 11.6 years old. The recipients’ post-transplant duration ranged from 2 to 80 months (Mean 17.6 ± 18.6 months). Only four (10%) of kidney transplant recipients studied had ever heard of CMV infection and only one recipient (2.5%) was aware that CMV infection could affect a transplanted kidney, and that CMV infection could be transmitted from the donor kidney graft to the recipient. One recipient (2.5%) was aware that blood transfusion could be a mode of transmission of CMV infection. None of the recipients was aware that CMV infection could be sexually transmitted. All the four recipients who were aware of CMV infection obtained the information from their doctors. Conclusion: Despite its significant impact on kidney transplant recipient and graft survival, the level of awareness of CMV infection and its relevance to kidney transplantation was very low among kidney transplant recipients. Transplant units in the study environment should include information and education about CMV infection and its impact on the transplant recipient and graft survival in their counseling programme for transplant recipients.

Effect of [Ca^(2+)]_i and Neuronal Mitochondria Transmembrane Potentials in Hippocampus of Murine Cytomegalovirus Infected Mice

To explore the effect of [-Ca^2＋]i and neuronal mitochondria transmembrane potentials in hippocampus of murine cytomegalovirus （MCMV） infected mice, newborn Balb/c mice were randomly divided into two groups： a virus inoculated group and a control group. After 56 days, single cell of hippocampus was isolated, and mitochondria transmembrane potentials and the intracellular free calcium level [-Ca^2＋]i in hippocampus were measured by means of flow cytometry （FCM）. Compared with the control group, the mitochondria transmembrane potentials was decreased （P〈0. 01 ） and the intracellular free calcium level [-Ca^2＋]i was increased （P〈0. 01） in inoculated group. The dysfunction of [-Ca^2＋]i and mitochondria transmembrane potentials in hippocampus may play an important role in the functional disorders in CMV-infected CNS.

Experimental Study of Mouse Cytomegalovirus Infected M ice

In order to investigate the human cytomegalovirus (HCMV) infection, the mouse cytomegalovirus (MCMV) infected mice were experimentally studied. 6 to 8 week old female BALB/C mice with immunosuppression were selected to undergo the MCMV inoculations: intracranial inoculation and peritoneal inoculation. MCMV of the infected mice in various organs and tissues were detected by using gal staining and in situ nucleic acid hybridization assay. The pathological cha nges were observed in HE staining paraffin embedded sections. It was found that all the MCMV infected mice showed the retardation of growth and development, an d feather looseness. Both intracranial inoculation of 10 4 PFU viruses or perit oneal inoculation of 10 6 PFU viruses resulted in the pathological changes, to some extent, of various organs and tissues in the mice. The pathological changes in liver were consistent with the amount of gal staining positive cells, in dicating the liver lesions were mainly caused by viral proliferation. It was als o found that the viruses in the immunosuppressed mice subjected to intracranial inoculation could spread to whole body organs, while the viruses in the immunosu ppres sed mice subjected to intrapeitoneal inoculation couldn't spread to the brain, s uggesting blood brain barrier could prevent the virus from spreading to the bra in.

Immunobiology of congenital cytomegalovirus infection of the central nervous system--the murine cytomegalovirus model

Congenital human cytomegalovirus infection is a leading infectious cause of long-term neurodevelopmental sequelae, including mental retardation and hearing defects. Strict species specificity of cytomegaloviruses has restricted the scope of studies of cytomegalovirus infection in animal models. To investigate the pathogenesis of congenital human cytomegalovirus infection, we developed a mouse cytomegalovirus model that recapitulates the major characteristics of central nervous system infection in human infants, including the route of neuroinvasion and neuropathological findings. Following intraperitoneal inoculation of newborn animals with mouse cytomegalovirus, the virus disseminates to the central nervous system during high-level viremia and replicates in the brain parenchyma, resulting in a focal but widespread, non-necrotizing encephalitis. Central nervous system infection is coupled with the recruitment of resident and peripheral immune cells as well as the expression of a large number of pro-inflammatory cytokines. Although infiltration of cellular constituents of the innate immune response characterizes the early immune response in the central nervous system, resolution of productive infection requires virus-specific CD8＋ T cells. Perinatal mouse cytomegalovirus infection results in profoundly altered postnatal development of the mouse central nervous system and long-term motor and sensory disabilities. Based on an enhanced understanding of the pathogenesis of this infection, prospects for novel intervention strategies aimed to improve the outcome of congenital human cytomegalovirus infection are proposed.

Long-term Impact of Intrauterine MCMV Infection on Development of Offspring Nervous System

This study examined the impacts of intrauterine murine cytomegalovirus（MCMV） infection on the long-term learning and memory of offspring.Sexually matured male and female BALB/C mice without MCMV infection were identified by ELISA and then mated.Seventy pregnant mice were randomly divided into the virus group（n=40） and the control group（n=30）,in which the pregnant mice were subjected to placenta inoculation of MCMV suspension（1 μL,1×106 PFU） or the same amount of cell culture medium,respectively,at gestational age of 12.5 days.Some pregnant mice [virus group（n=20）,control group（n=15）] were sacrificed by cervical dislocation at gestational age of 18.5 days,and the head circumference and brain weight of the mouse fetuses were measured,and the MCMV infection in their brain tissues was detected by PCR.The other pregnant mice [virus group（n=20）,control group（n=15）] delivered naturally,and the learning and memory capability of the offspring at 70-day-old was analyzed by Morris water maze test.The results showed that 28.57% mouse fetuses in the virus group developed viral infection in the brain.Their head circumference and brain weight were significantly reduced as compared with those in the control group（P0.01）.The Morris water maze test revealed that the mouse offspring in the control group found the platform with straight-line trajectories after training.In contrast,the counterparts in the virus group intended to enter the central area,but looked for the platform with a circular trajectory.And the infected mice exhibited prolonged swimming distance and swimming latency（P0.01）.It was concluded that：（1） placenta inoculation of MCMV can cause fetal brain infection and intrauterine development retardation;（2） the offspring of MCMV placenta inoculation mice showed a long-term decline in learning and memory capability.

Cytomegalovirus colitis followed by ischemic colitis in a non-immunocompromised adult:A case report

We report a rare case of cytomegalovirus(CMV) colitis followed by severe ischemic colitis in a nonimmunocompromised patient. An 86-year-old woman was admitted after experiencing episodes of vomiting and diarrhea. The next day, hematochezia was detected without abdominal pain. The initial diagnosis of ischemic colitis was based on colonoscopy and histological findings. The follow-up colonoscopy revealed a prolonged colitis. Immunohistochemical staining detected CMVpositive cells following conservative therapy. Intravenous ganciclovir therapy led to successful healing of ulcers and disappearance of CMV-positive cells. The prevalence of CMV infection is common in adults. CMV colitis is relatively common in immunocompromised patients; however, it is rare in immunocompetent patients. In our case, CMV infection was allowed to be established due to the disruption of the colonic mucosa by the prior severe ischemic colitis. Our experience suggests that biopsies may be necessary to detect CMV and the prompt management of CMV colitis should be instituted when intractable ischemic colitis is observed.

Microbiology laboratory and the management of motherchild varicella-zoster virus infection

Varicella-zoster virus, which is responsible for varicella(chickenpox) and herpes zoster(shingles), is ubiquitous and causes an acute infection among children, especially those aged less than six years. As 90% of adults have had varicella in childhood, it is unusual to encounter an infected pregnant woman but, if the disease does appear, it can lead to complications for both the mother and fetus or newborn. The major maternal complications include pneumonia, which can lead to death if not treated. If the virus passes to the fetus, congenital varicella syndrome, neonatal varicella(particularly serious if maternal rash appears in the days immediately before or after childbirth) or herpes zoster in the early years of life may occur depending on the time of infection. A Microbiology laboratory can help in the diagnosis and management of mother-child infection at four main times:(1) when a pregnant woman has been exposed to varicella or herpes zoster, a prompt search for specific antibodies can determine whether she is susceptible to, or protected against infection;(2) when a pregnant woman develops clinical symptoms consistent with varicella, the diagnosis is usually clinical, but a laboratory can be crucial if the symptoms are doubtful or otherwise unclear(atypical patterns in immunocompromised subjects, patients with post-vaccination varicella, or subjects who have received immunoglobulins), or if there is a need for a differential diagnosis between varicella and other types of dermatoses with vesicle formation;(3) when a prenatal diagnosis of uterine infection is required in order to detect cases of congenital varicella syndrome after the onset of varicella in the mother; and(4) when the baby is born and it is necessary to confirm a diagnosis of varicella(and its complications), make a differential diagnosis between varicella and other diseases with similar symptoms, or confirm a causal relationship between maternal varicella and malformations in a newborn.

Diagnostic value of antigenemia assay for cytomegalovirus gastrointestinal disease in immunocompromised patients

AIM:To investigate the utility of the cytomegalovirus(CMV)antigenemia assay for the diagnosis of CMV gastrointestinal disease(GID). METHODS:One hundred and thirty immunocompromised patients were enrolled in this study.Patients with a history of anti-CMV treatment and who had not undergone examination using the antigenemia assay were excluded.CMV-GID was defined as the detection of large cells with intranuclear inclusions alone or associated with granular cytoplasmic inclusions by biopsy.Biopsy sections were stained with hematoxylin and eosin and immunohistochemically stained with anti-CMV.We evaluated the association between CMV-GID and patient characteristics(symptoms,underlying disease,medication,leukocyte counts,and antigenemia assay).All patients were checked with an human immunodeficiency virus(HIV)antibody test before endoscopic examination.White blood cell(WBC)counts were obtained from medical records within 1 wk of endoscopy.Leukopenia was defined as a total WBC count<5000 cells/mm 3 . For HIV patients,we also checked CD4+counts from medical records. RESULTS:A total of 99 patients were retrospectively selected for analysis.Of the immunocompromised patients,19 had malignant disease,18 had autoimmune disease,19 had disorders of biochemical homeostasis, three had undergone transplantation,and 45 had HIV infection.A total of 50 patients had received immunosuppressive therapy.No patients had inflammatory bowel disease.Fifty-five patients were diagnosed as having CMV-GID.Univariate analysis indicated an association between HIV infection,leukopenia,and positive antigenemia and CMV-GID(P<0.05).Multivariate analysis using logistic regression revealed that HIV infection and positive antigenemia were the only independent factors related to CMV-GID(P<0.01).The sensitivity,specificity,positive predictive value,and negative predictive value of antigenemia for CMV-GID were 65.4%,93.6%, 91.9%,and 71.0%,respectively.In a subgroup analy-sis,patients with leukopenia displayed low sensitivity and high specificity.Minimal differences in accuracy were seen among patients with or without leukopenia. HIV-infected patients displayed low sensitivity and high specificity.Accuracy barely differed between HIV-positive and-negative patients.In HIV-infected patients, CD4 count<50 cells/μL resulted in low sensitivity and high specificity.Differences in accuracy among patients were minor,regardless of CD4 count.In patients who had undergone both quantitative real-time polymerase chain reaction(PCR)and antigenemia assay,real-time PCR was slightly more accurate in terms of sensitivity than the antigenemia assay;however,this difference was not statistically significant(P=0.312). CONCLUSION:If the antigenemia test is positive,endoscopic lesions are acceptable for the diagnosis of CMVGID without biopsy.The accuracy is not affected by HIV infection and leukopenia.Either PCR or the antigenemia assay are valid.

Human cytomegalovirus induces alteration of β-actin mRNA and microfilaments in human embryo fibroblast cells

Objective: To investigate the infection of human embryo fibroblast cell line HF cells by CMV as well as the effects of CMV on β-actin mRNA and microfilaments. Methods: HF cells shape was observed after the infection of CMV.RT-PCR assay was used to detect the mRNA expression of CMV immediate early (IE) gene, β-actin and GAPDH genes of HF cells infected by CMV. CMV particles and cell microfilaments were detected with electron microscope. Results: Shape of HF cell changed after the infection by CMV. HF cells infected by CMV could express IE mRNA and the expression of β-actin mRNA decreased in a time-and titer-dependent manner compared with the uninfected HF cells whose expression of GAPDH mRNA did not change much. CMV particles were found with electron microscope in the cells. Microfilaments were ruptured and shortened after the infection of CMV. Conclusion: CMV can not only infect human embryo fibroblast cells line HF cells and replicate in the cells, but can also affect the expression of β-actin mRNA and the microfilaments.

Clinical Analysis of Cytomegalovirus Infecion in 54 Adults

Fifty-four cases, subdivided into 3 forms, of cytomegalovirus (CMV) infection in adultswere analyzed.(1) CMV mononucleosis: It typically had hypepoyrexia with mild symptoms. Transientabnormal liver functions and infectious-monocucleosis-like hematologic features with a negative EB virusmarker were noted. Though its complications were complex,its prognosis was satisfactory. (2) Hepatitiscaused by CMV:The clinical features might be similar to those of other viral hepatitis. Of all types,theacute icteric hepatitis recovered the quickest, much quicker than hepatitis with single rise of AIT. Thenonicteric type recovered the slowest. The prognosis of purc CMV hepatitis was usually good.(3)CMVinfections in immunuo-compromized patients: 75% of the cases were infected after immunosuppressivetherapy. They usually had hyperpyrexia with fatal complications. Half of the cases usually died of theillness. The authors suggest that a physician should bear in mind the possibility of CMV infection inpatients with hyperpyrexia, hepatitis or pneumonia of unknown origin,particularly in immuno-compromized cases.

Congenital cytomegalovirus infection and advances in murine models of neuropathogenesis

Congenital human cytomegalovirus(c HCMV) has been a well-known infectious cause of morbidity and mortality in newborns and a contributing factor for neurological disorders in infants(Crough and Khanna,2009).