1/54. Hyperimmunoglobulin therapy for a twin fetus with cytomegalovirus infection and growth restriction.OBJECTIVE: cytomegalovirus immunoglobulin was administered to a pregnant woman with primary cytomegalovirus infection and placental involvement of 1 twin fetus, in whom growth restriction had developed. STUDY DESIGN: Inhibition of viral activity was attempted by administration of high-titer cytomegalovirus neutralizing antibodies for therapy of the involved fetoplacental unit and prevention of cytomegalovirus infection in the uninfected twin fetus. RESULTS: After cytomegalovirus immunoglobulin infusions the placental edema decreased and the infected fetus started to grow once again, showing at birth only hepatosplenomegaly associated with viruria and cytomegalovirus deoxyribonucleic acidemia. Moreover, cytomegalovirus immunoglobulin g avidity increased and cell-mediated immunity improved. The other twin, who had negative results of cytomegalovirus culture and deoxyribonucleic acid detection at birth, was found to have cytomegalovirus deoxyribonucleic acid in the urine after 1 week. From the age of 9 months, however, both twins had persistent negative results of cytomegalovirus deoxyribonucleic acid detection. CONCLUSION: Although large-scale studies are needed to establish the real efficacy and the best therapeutic regimen, cytomegalovirus immunoglobulin may be considered for treatment or prevention of fetal cytomegalovirus infection.- - - - - - - - - - ranking = 1keywords = cytomegalovirus (Clic here for more details about this article) |
2/54. Multi-system cytomegalovirus fetopathy by recurrent infection in a pregnant woman with hepatitis B.A pregnant woman with acute hepatitis b virus (HBV) infection had her second pregnancy terminated at 25 weeks' gestation because of fetal ascites and ventriculitis. meconium peritonitis was also found at autopsy. No HBV dna but cytomegalovirus (CMV) dna was detected in the fetal liver and ascitic fluid. Recurrent maternal CMV infection was demonstrated by pre-existing CMV IgG antibodies, high IgG avidity and low IgM levels. After abortion, the patient developed chronic active hepatitis. Nevertheless, having become pregnant again with a new partner, she had an uneventful third pregnancy and gave birth to a healthy boy.- - - - - - - - - - ranking = 0.33333333333333keywords = cytomegalovirus (Clic here for more details about this article) |
3/54. Severe fetal cytomegalic inclusion disease after documented maternal reactivation of cytomegalovirus infection during pregnancy.Recurrent cytomegalovirus infection during pregnancy is considered less dangerous for the fetus than primary infection. We present a case of severe fetal cytomegalic inclusion disease after maternal reactivation of cytomegalovirus during the first trimester of pregnancy. The possibility of such fetal injury is an argument for prenatal diagnosis in seropositive pregnant women when ultrasonographic findings suggest cytomegalovirus infection.- - - - - - - - - - ranking = 0.46666666666667keywords = cytomegalovirus (Clic here for more details about this article) |
4/54. Congenital cytomegalovirus infection: three autopsy case reports.We report three autopsy cases of congenital cytomegalovirus (CMV) infection in fetuses with a review of literature. The clinical manifestations in these cases of congenital CMV infection include intrauterine fetal death, hydrops fetalis, and CMV pneumonia associated with cardiovascular defect. The pathological characteristics were as follows: 1) the kidney was the most frequently involved organ, followed by lung and liver, 2) CMV inclusions were found predominantly in epithelial cells and to a lesser degree in endothelial cells, 3) intrahepatic bile duct epithelial cells were frequently involved, and 4) inflammatory reaction around CMV inclusions was not prominent in the early stage of pregnancy. Diagnostic confirmation was obtained by in situ hybridization (ISH) using a biotinylated CMV-dna probe, which demonstrated intranuclear inclusions and sometimes recognized cells that did not show intranuclear inclusion.- - - - - - - - - - ranking = 0.33333333333333keywords = cytomegalovirus (Clic here for more details about this article) |
5/54. Hepatotoxicity with antiretroviral treatment of pregnant women.BACKGROUND: Hepatotoxicity in adults with human immunodeficiency virus (hiv) infection has been associated with all classes of antiretroviral drugs and coinfection with hepatitis B and C virus. We treated two hiv-infected pregnant women in whom hepatotoxicity developed after initiating antiretroviral therapy. CASES: The first woman developed icterus, jaundice, hyperbilirubinemia, and elevated serum aminotransferase levels approximately 5 months after beginning combination antiretroviral therapy with zidovudine, lamivudine, and efavirenz. serum aminotransferase abnormalities improved after discontinuation of antiretroviral medications. The second woman had similar symptoms and laboratory abnormalities 3 months after initiation of zidovudine, lamivudine, and nelfinavir. Despite initial improvement after discontinuing her antiretroviral medications, fulminant hepatic failure developed and she died. Both patients tested negative for hepatitis a, B, and C; Epstein-Barr virus; and cytomegalovirus. There was no history of illicit drug use, alcohol use, or blood transfusions in either case. CONCLUSION: We emphasize the need for careful monitoring for hepatotoxicity after initiation of antiretroviral therapy.- - - - - - - - - - ranking = 0.066666666666667keywords = cytomegalovirus (Clic here for more details about this article) |
6/54. Coxsackie virus infection of the placenta associated with neurodevelopmental delays in the newborn.OBJECTIVE: To determine if viral infection of the placenta was associated with long-term neurodevelopmental delays in the newborn. methods: Placental tissue from seven newborn infants with severe respiratory failure and subsequent neurodevelopmental abnormalities as well as ten normal controls and five cases of known placental infection (cytomegalovirus, herpes simplex virus, and parvovirus) were tested by in situ hybridization or reverse transcriptase in situ polymerase chain reaction (PCR) for adenovirus, coxsackie virus, cytomegalovirus, Epstein Barr virus, herpes simplex virus, influenza a virus, picornavirus, polyoma virus, parvovirus, respiratory syncytial virus, rotavirus, and varicella zoster virus. RESULTS: Coxsackie virus rna was detected in six of the seven cases, and in none of the ten normal controls or five cases with known viral infection. Viral rna localized primarily to the Hofbauer cells and trophoblasts of the terminal villi. Immunohistochemical analysis for the coxsackie virus antigen VP1 yielded equivalent results. CONCLUSIONS: In utero coxsackie virus of the placenta is associated with the development of severe respiratory failure and central nervous system sequelae in the newborn. This underscores the importance of detailed pathologic and viral examination of the placenta in cases of systemic illness in the newborn.- - - - - - - - - - ranking = 0.13333333333333keywords = cytomegalovirus (Clic here for more details about this article) |
7/54. liver dysfunction in late pregnancy: cytomegalovirus-induced hepatitis or the hellp syndrome?A 27-year-old primiparous preeclamptic woman developed a skin rash in late pregnancy and was persistently febrile for 10 days after giving birth. Blood tests suggested that she developed the hellp syndrome and had concomitant cytomegalovirus (CMV) infection. hemolysis, slightly impaired liver function, and thrombocytopenia were explainable by either only the CMV infection or only the hellp syndrome. A literature review of a limited number of such cases and our case suggests that laboratory data in patients with CMV infection can mimic those of the hellp syndrome. Thus, it may be important to consider CMV infection as a possible cause of abnormal laboratory data similar to the hellp syndrome.- - - - - - - - - - ranking = 0.33333333333333keywords = cytomegalovirus (Clic here for more details about this article) |
8/54. Real-time PCR quantification of human cytomegalovirus dna in amniotic fluid samples from mothers with primary infection.A real-time PCR assay was developed to quantify human cytomegalovirus (HCMV) dna in amniotic fluid (AF) samples collected from 30 pregnant women with primary HCMV infection as detected either from HCMV-immunoglobulin g (IgG) seroconversion or by the presence of HCMV-specific IgG and IgM associated with a low IgG avidity. Clinical information available for each case included ultrasonographic examination and fetal or newborn outcome. HCMV infection of fetuses or newborns was confirmed for the 30 studied cases. AF samples were subdivided into three groups. In group A (n = 13), fetuses presented major ultrasound abnormalities, and pregnancy was terminated. In group B (n = 13), fetuses had normal ultrasound findings, the pregnancy went to term, and the newborns were asymptomatic at birth. In group C (n = 4), fetuses had no or minor ultrasonographic signs, and pregnancy was terminated. The HCMV dna load values in AF samples were significantly higher in group A (median, 2.8 x 10(5) genome equivalents [GE]/ml) than in group B (median, 8 x 10(3) GE/ml) (P = 0.014). Our findings suggest that HCMV load level in AF samples correlates with fetal clinical outcome but might also be dependent on other factors, such as the gestational age at the time of AF sampling and the time elapsed since maternal infection.- - - - - - - - - - ranking = 0.33333333333333keywords = cytomegalovirus (Clic here for more details about this article) |
9/54. 1: Infections in pregnant women.Some infections are more serious in pregnant than non-pregnant women because of the potential for vertical transmission to the fetus or infant (eg, varicella, rubella, cytomegalovirus infection, toxoplasmosis and listeriosis). Pre-pregnancy or routine antenatal screening for presence of, or susceptibility to, some of these infections and appropriate management can prevent adverse fetal or perinatal outcomes; screening should include rubella IgG, hepatitis B surface antigen, serological tests for syphilis and hiv antibody. If certain other vertically transmissible infections are suspected because of a positive antenatal test result, confirmatory tests for maternal and, if indicated, fetal infection are essential before intervention is considered (eg, cytomegalovirus infection). For some vertically transmissible infections that are not readily preventable, appropriate management of maternal infection can reduce fetal damage (eg, toxoplasmosis).- - - - - - - - - - ranking = 0.13333333333333keywords = cytomegalovirus (Clic here for more details about this article) |
10/54. Recurrent cytomegalovirus infection during pregnancy: ultrasonographic diagnosis and fetal outcome.Fetal infection as a consequence of recurrent disease is uncommon. We present a case of recurrent cytomegalovirus infection in the second trimester of pregnancy. Fetal infection was detected through severely abnormal findings on ultrasound examination and verified by detecting cytomegalovirus dna in the amniotic fluid and cytomegalovirus-specific immunoglobulin m antibodies in the fetal blood and associated pancytopenia. Because of the severity of the infection, a fatal outcome was predicted. A cesarean section was performed at 33 5 weeks of gestation; the child died shortly after birth.- - - - - - - - - - ranking = 0.46666666666667keywords = cytomegalovirus (Clic here for more details about this article) |
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