1/11. Stealth adaptation of an African green monkey simian cytomegalovirus.dna extracted from cultures of a cytopathic virus isolated from a patient with chronic fatigue syndrome was cloned into pBluescript plasmid. The nucleotide sequences of the plasmid inserts were analyzed using the BlastN and BlastX programs of the National Center for biotechnology Information. In confirmation of earlier studies, many of the sequences show partial homology to various regions within the genome of human cytomegalovirus (HCMV). The matching regions were unevenly distributed throughout the HCMV genome. No matches were seen with either the UL55 or the UL83 genes, which provide the major antigenic targets for anti-HCMV cytotoxic T-cell-mediated immunity. This finding is consistent with the notion that certain viruses can avoid immune elimination by deleting genes required for effective antigenic recognition by the cellular immune system. The term "stealth" has been applied to such viruses. Comparisons were also made between the sequences of the stealth virus and the limited sequence data available on cytomegaloviruses from rhesus monkeys and from African green monkeys. These comparisons unequivocally establish that the virus was derived from an African green monkey simian cytomegalovirus.- - - - - - - - - - ranking = 1keywords = fatigue (Clic here for more details about this article) |
2/11. infectious mononucleosis-like syndrome and gastrointestinal disorders in acute acquired cytomegalovirus infection.Acute acquired cytomegalovirus (CMV) infection occurring in an 18-year-old Brazilian woman is reported. She presented with high fever, diarrhoea, colicky abdominal pain, vomiting, arthralgia and asthenia. CMV IgG Ab (151) and CMV IgM Ab were positive. ELISA was confirmed by immunofluorescence. The patient received symptomatic treatment and recovered fully. It is unusual to have features of infectious mononucleosis-like syndrome and gastrointestinal disorders in the same patient.- - - - - - - - - - ranking = 199656.31243409keywords = mononucleosis-like syndrome, mononucleosis-like (Clic here for more details about this article) |
3/11. Distal cholangiocarcinoma associated with papillitis with viral CMV inclusions.cytomegalovirus (CMV) infections are usually described in immunodeficient patients. In immunocompetent patients active infection is uncommon, consisting usually of a mononucleosis-like syndrome. Numerous reports show that CMV is a potential pathogen in the gastrointestinal tract, even in immunocompetent patients, where it can produce lesions from the mouth to the anus. We report herein an uncommon association of chronic inflammation of the papilla and viral CMV inclusions with distal cholangiocarcinoma in a 72-year-old woman who presented jaundice, choluria, acholia and generalized pruritus. At laparotomy, dilatation of the bile ducts and an enlarged head of the pancreas were found. Pancreatoduodenectomy was performed. pathology revealed an enlarged papilla, due to chronic inflammation with CMV inclusions. Histological analysis revealed moderately differentiated ductal adenocarcinoma of the distal bile tract.- - - - - - - - - - ranking = 39931.262486819keywords = mononucleosis-like syndrome, mononucleosis-like (Clic here for more details about this article) |
4/11. Protracted mononucleosis-like illness associated with acquired cytomegalovirus infection in a previously healthy child: transient cellular immune defects and chronic hepatopathy.Ordinarily, severe disease due to acquired cytomegalovirus (CMV) infection does not occur in immunocompetent children. We describe a previously healthy boy who acquired primary CMV infection at approximately 2 years of age and experienced a 2-year-long debilitating multisystem illness from which he ultimately recovered. Clinical features of this illness included fatigue, poor weight gain, pallor, unexplained fever, musculoskeletal complaints, drenching night sweats, lymphadenopathy, and massive hepatosplenomegaly. Laboratory abnormalities included elevated erythrocyte sedimentation rate, lymphocytosis, and elevated immune complex levels. Cellular immune function was impaired during the illness but was demonstrably normal during convalescence, and there was no other evidence for a known immunodeficiency state. Immunoblot analysis showed enhanced antibody response to a 66-kd infected cell protein after symptomatic recovery. Despite consistently normal indices of hepatic function, liver enlargement persisted after other symptoms had resolved. liver biopsy demonstrated a mononuclear cell portal tract infiltrate with fibrosis, but CMV could not be demonstrated directly in this tissue. Primary CMV infection has not been reported previously to cause the persistent symptoms seen in this child.- - - - - - - - - - ranking = 31538.929064399keywords = mononucleosis-like, fatigue (Clic here for more details about this article) |
5/11. Spontaneous cytomegalovirus mononucleosis-like syndrome and aseptic meningitis.The spontaneous development of a cytomegalovirus infection in a healthy adult is described. This illness manifested with fever, headache, malaise, an absolute lymphocytosis with atypical lymphocytes, and liver function abnormalities, but without tonsillitis, pharyngitis, lymphadenopathy, or splenomegaly. Aseptic meningitis also was present. The pathogenesis of cytomegalovirus mononucelosis and its relationship to other related syndromes are discussed.- - - - - - - - - - ranking = 159725.04994727keywords = mononucleosis-like syndrome, mononucleosis-like (Clic here for more details about this article) |
6/11. Co-infection with human immunodeficiency virus-type 1 (hiv-1) and cytomegalovirus in two intravenous drug users.A mononucleosis-like illness is frequently recognized retrospectively as the first manifestation of infection with human immunodeficiency virus-type 1 (hiv-1). This acute but transient retroviral syndrome may include symptoms such as malaise, fever, sweats, myalgia, arthralgia, maculopapular rash, diarrhea, and lymphocytic meningitis. We observed two intravenous drug users who developed a severe, febrile illness with subsequent oral thrush (one also had biopsy-proven esophageal candidiasis). Both patients had weight loss, arthralgia, myalgia, and fatigue. These symptoms occurred two weeks after needle-sharing and persisted for 7 weeks in one patient and 10 weeks in the other. Both patients had serologic evidence for both acute hiv-1 and cytomegalovirus infection. cytomegalovirus enhances hiv-1 replication in vitro, presumably by stimulating hiv-1 gene expression. Thus, the observed syndrome suggests that this viral interaction may be clinically significant because it appears to cause severe additional morbidity, which is not typical for primary infection with hiv-1. After 6 months of follow-up, one patient is completely asymptomatic but shows markedly reduced CD4 lymphocytes. The other patient developed persistent lymphadenopathy after the acute illness, but is feeling well 21 months after infection.- - - - - - - - - - ranking = 7885.4822660997keywords = mononucleosis-like, fatigue (Clic here for more details about this article) |
7/11. cytomegalovirus-associated stage 4S neuroblastoma relapsed stage 4.neuroblastoma is one of the most frequent solid tumors in childhood, rarely recurrent after five years from diagnosis. cytomegalovirus (CMV), a major pathogen causing congenital birth defects and severe opportunistic diseases, has been shown to have teratogenic, immunodepressive and oncogenic properties. The case of a girl with stage 4S neuroblastoma diagnosed at three months and relapsed as stage 4 five years later is reported. In both circumstances, active CMV infection was revealed by positive CMV-specific IgM and IgA antibodies, CMV-DNAemia and CMV culture. At three months, the patient presented with subcutaneous nodules, hepatosplenomegaly and increased aminotransferase levels, and the opsolonus-myoclonus syndrome. Mental retardation developed later on. At 5 years, relapsed neuroblastoma was preceded by a mononucleosis-like syndrome concomitant with active CMV infection and decreased levels of immune cells and natural killer activity. Clinical, virologic, and immunologic findings suggest an immune-mediated pathogenic role for CMV in this tumor.- - - - - - - - - - ranking = 39931.262486819keywords = mononucleosis-like syndrome, mononucleosis-like (Clic here for more details about this article) |
8/11. Simian cytomegalovirus-related stealth virus isolated from the cerebrospinal fluid of a patient with bipolar psychosis and acute encephalopathy.A cytopathic 'stealth' virus was cultured from the cerebrospinal fluid of a patient with a bipolar psychotic disorder who developed a severe encephalopathy leading to a vegetative state. dna sequencing of a polymerase chain reaction-amplified product from infected cultures has identified the virus as an African green monkey simian cytomegalovirus (SCMV)-related stealth virus. The virus is similar to the SCMV-related stealth virus isolated from a patient with chronic fatigue syndrome. The findings support the concepts that stealth viruses can account for a spectrum of dysfunctional brain diseases and that some of these viruses may have arisen from live polio viral vaccines.- - - - - - - - - - ranking = 1keywords = fatigue (Clic here for more details about this article) |
9/11. Detection of rna sequences in cultures of a stealth virus isolated from the cerebrospinal fluid of a health care worker with chronic fatigue syndrome. Case report.A cytopathic stealth virus was cultured from the cerebrospinal fluid of a nurse with chronic fatigue syndrome. Reverse transcriptase-polymerase chain reaction (RT-PCR) performed on the patient's culture yielded positive results with primer sets based on sequences of a previously isolated African green monkey simian-cytomegalovirus-derived stealth virus. The same primer sets did not yield PCR products when tested directly on dna extracted from the cultures. The findings lend support to the possibility of replicative rna forms of certain stealth viruses and have important implications concerning the choice of therapy in this type of patient.- - - - - - - - - - ranking = 5keywords = fatigue (Clic here for more details about this article) |
10/11. Successful treatment with ganciclovir of a HIV endstage patient with adrenal insufficiency.We report on a 31-year-old AIDS patient who presented with rapid progressive fatigue, weakness, weight loss and hyperpigmentation. endoscopy showed an ulcerous CMV gastritis with the histological hallmarks of this disease. In addition, laboratory tests revealed the constellation of an adrenal insufficiency with low plasma levels of sodium and increased levels of potassium and ACTH. After initiation of ganciclovir treatment, the CMV gastritis healed and the electrolyte abnormalities were resolved within 2 weeks. We assume that a CMV adrenalitis was treated in a reversible stage. The literature on CMV adrenalitis is reviewed to support this conclusion.- - - - - - - - - - ranking = 1keywords = fatigue (Clic here for more details about this article) |
| | Next -> |