Background
Methods
Population
Congenital | |||
---|---|---|---|
Patient No | Age (day/month) | IgM | Clinical and Laboratory data |
1 | 5 d | + | IUGR, cerebral calcifications. |
2 | 21 d | - | Ascites, renal problems, elevated liver enzymes. |
3 | 6 d | + | SGA, purpura, hepatosplenomegaly |
4, 8, 29 | 5 d, 5 d, 28 d | -, +, + | SGA |
5 | 18 d | + | Petechiae, hepatosplenomegaly, jaundice |
6, 14., 32 | 5 d, 8 d, 8 d | +, +, + | Hepatosplenomegaly, cerebral calcifications |
7 | 14 d | + | Sepsis, thrombocytopenia. |
9 | 20 m | - | AWGA, purpura, elevated liver enzymes. |
10 | 5 d | + | SGA, cerebral microcalcifications, microcephaly |
11 | 5 d | - | SGA, purpura, hepatosplenomegaly, thrombocytopenia |
12 | 4 d | - | AWGA, purpura, elevated liver enzymes, trombocytopenia. |
13 | 11 d | + | Sepsis, petechiae, thrombocytopenia |
15, 21, 33 | 5 d, 5 d, 5 d | -, +, - | SGA, purpura, HIV+. |
16 | 6 d | - | Cerebral calcifications, thrombocytopenia, HIV+ mother. |
17 | 5 d | + | Foetal dystrophy, inclusion-bearing cells in urine. |
18 | 14 d | S/s | IUGR, sepsis, foetal dystrophy |
19 | 8 d | + | Hepatosplenomegaly, sepsis, died of hepatic failure |
20 | 18 d | + | SGA, hydrocephalus, respiratory problems |
22 | 3 m | S/s | Cerebral calcifications, congenital toxoplasmosis |
23 | 24 d | - | Cholestasis, purpura, cerebral calcifications, elevated liver enzymes, sepsis. |
24 | 5 d | - | Microcephaly, cerebral calcifications (irregular and punctate), thrombocytopenia |
25 | 5 d | + | AWGA, hepatosplenomegaly, sepsis, jaundice. |
26 | 3 m | - | Chorioretinitis |
27 | 5 d | - | SGA, hepatosplenomegaly, petechiae, anaemia, cholestasis |
28 | 5 d | + | SGA, purpura, cerebral calcifications, thrombocytopenia, splenomegaly, elevated liver enzymes |
30 | 5 d | + | Hepatosplenomegaly, purpura |
31 | 5 m | - | RNPT, AWGA, seizures, maturational delay, palsy at age one year |
Perinatal
| |||
39 | 40 d | - | SGA, petechiae, hepatomegaly, respiratory problems. |
41 | 5 m | + | HIV+, cerebral calcifications, hepatosplenomegaly, anaemia |
47 | 34 d | + | Neonatal jaundice |
50 | 8 m | - | SGA, Hepatosplenomegaly, elevated liver enzymes, anaemia, jaundice at age 2 months |
Congenital or Perinatal
| |||
34, 37, 48 | 3 m, 8 m, 7 m | -, -, S/s | Hepatosplenomegaly, HIV+ |
35 | 4 m | + | Jaundice, biliary atresia |
36 | 63 d | + | Anaemia, hepatosplenomegaly, malnutrition, hyperbilirubinemia |
38, 43 | 4 m, 3 m | -, - | Petechiae, hyperbilirubinemia, splenomegaly |
40 | 40 d | - | Ascitis, renal problems, elevated liver enzymes |
42 | 42 d | S/s | SGA |
44 | 3 m | + | Premature, scanty maternal contact |
45 | 24 m | - | Malnutrition, pancytopenia. |
46 | 12 m | + | Aplastic crisis |
49 | 4 m | + | SGA, hepatosplenomegaly, jaundice, anaemia, petechiae. |
51 | 2 m | + | Sepsis, cyanosis, vomiting |
52 | 1 m | S/s | Petechiae, jaundice, anaemia, hepatosplenomegaly |
53 | 5 m | + | Mental retardation, anaemia |
54 | 2 m | - | RNPT, SGA, IUGR, anaemia, microcephaly, tricuspid valve insufficiency |
55 | 3 m | - | SGA, rash, fever spikes |
56, 58 | 5 m, 33 d | -, - | SGA, respiratory problems. |
57 | 34 d | + | IUGR, sepsis, hepatomegaly, oesophageal atresia, elevated liver enzymes |
59 | 26 d | - | SGA, HIV+ mother |
60 | 38 d | + | IUGR, microcephaly, jaundice |
61 | 6 m | - | Normal at birth, neutropenia |
Processing of clinical samples
Isolation of CMV in cell cultures and confirmation by an indirect immunofluorescence test
Serology
CMV-PCR
Sample preparation
Tissue culture
Urine
Reaction
Primers | Sequence (5-3)' | Product Length (pb) | Position in the gene | References |
---|---|---|---|---|
IE | tgaggataagcgggagatgt | 242 | 1729–1748 | Jiwa N et al. (1989) |
actgaggcaagttctgcagt | 1951–1970 | |||
gB | Outer | |||
accaccgcactgaggaatgtcag | 150 | 1942–1966 | Darlington et al. (1985) | |
tcaatcatgcgtttgaagaggta | 2067–2091 | |||
inner | ||||
accaccgcactgaggaatgtcag | 100 | 1967–1989 | ||
tcaatcatgcgtttgaagaggta | 2066–2040 | |||
LA | cacctgtcaccgctgctatatttgc | 400 | 1967–1989 | Demmler G et al. (1998) |
caccacgcagcggcccttgatgttt | 2066–2040 |
Specificity of PCR reaction
PCR positivity rates of reaction
Results
PCR positivity rates
PCR from CMV isolates
PCR of urine samples using primers for the gB region
Samples
|
Methods
| infection | Positive (%) | Total positive (%) |
---|---|---|---|---|
Positive culture
| PCR | Congenital | 33 (100) | 61 (100) |
Perinatal ** | 28 (100) | |||
Urine
| Direct PCR without DNA release | Congenital | 24 (73) | 34 (56) |
Perinatal** | 10 (36) | |||
Urine
| n-PCR | Congenital | 33 (100) | 59 (97) |
Perinatal** | 26 (93)* |