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Gueudry J, Bodaghi B. Advances in the microbiological diagnosis of herpetic retinitis. FRONTIERS IN OPHTHALMOLOGY 2022; 2:990240. [PMID: 38983563 PMCID: PMC11182275 DOI: 10.3389/fopht.2022.990240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Accepted: 08/24/2022] [Indexed: 07/11/2024]
Abstract
Viral retinitis associated with herpesvirus is one of the most severe forms of uveitis and is a potentially sight-threatening ophthalmologic disease. The prognosis is poor and a rapid and aggressive management is necessary to improve the visual and sometimes vital prognosis of these patients. The treatments used are not without side effects, while many differential diagnoses exist, such as toxoplasmic retinochoroiditis, syphilitic retinitis, endogenous endophthalmitis and intraocular lymphoma. Causatives viruses are herpes simplex virus, varicella-zoster virus, and cytomegalovirus, which require rapid detection in ocular fluid, mainly aqueous humor. However, only a small amount of intraocular fluid is available for analysis. Advances in microbiological diagnostic techniques therefore were key factors in improving the management of these diseases. Historically, the diagnosis was based on immunological tests but more recently advances in molecular biology, in particular polymerase chain reaction, have played a crucial role to obtain a reliable and rapid diagnosis of viral retinitis associated with herpesvirus, as discussed in this review.
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Affiliation(s)
- Julie Gueudry
- Department of Ophthalmology - Charles Nicolle University Hospital, CHU Charles Nicolle, Rouen, France
| | - Bahram Bodaghi
- Department of Ophthalmology, DHU ViewRestore, Sorbonne Université, Pitié Salpêtrière Hospital, Paris, France
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Bhattacharya D, Panigrahi I, Chaudhry C. Clinical profile of symptomatic congenital cytomegalovirus infection: cases from a tertiary hospital in north India. Trop Doct 2020; 50:282-284. [PMID: 32437297 DOI: 10.1177/0049475520923491] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We retrospectively analysed the records of nine infants with polymerase chain reaction proven congenital cytomegalovirus (CMV) infection, of which 66% were born preterm. Microcephaly was a universal finding, followed by hepatosplenomegaly in 89%, while chorioretinitis was seen in only 44% cases. The mean age at diagnosis was 3.5 months. Neuroimaging was abnormal in 78%, with ventriculomegaly being the most common finding followed by T2/FLAIR white matter abnormalities, periventricular cysts and intracranial haemorrhage.
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Affiliation(s)
- Deepanjan Bhattacharya
- Junior Resident, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Inusha Panigrahi
- Professor, Genetic Metabolic Unit, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Chakshu Chaudhry
- Senior Resident (DM student), Genetic Metabolic Unit, Department of Pediatrics, Advanced Pediatrics Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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Mamuye Y, Nigatu B, Bekele D, Getahun M. Maternal and Congenital cytomegalovirus infection and zero rubella IgM prevalence in newborns in St.Paul's Hospital Millennium Medical College. BMC Res Notes 2016; 9:476. [PMID: 27769314 PMCID: PMC5073938 DOI: 10.1186/s13104-016-2274-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 10/11/2016] [Indexed: 11/30/2022] Open
Abstract
Background Maternal cytomegalovirus (CMV) and Rubella infections result in adverse neonatal outcomes. Both CMV and Rubella are more widespread in developing countries and in communities with lower socioeconomic status. Thus, the aim of this study was to determine IgM specific to CMV and Rubella among newborns and Maternal CMV-seroprevalence and to identify risk factors. Method and finding Using cross sectional study design a total of 312 (156 newborns and 156 mothers) study participants were recruited by simple random sampling technique from gynecology outpatient department (OPD) and ward, starting from April 1, 2015 to June 30, 2015. Cord and venous blood samples were collected from all participants and structured questionnaire was introduced to gather risk factor related data. ELISA was used to detect CMV and Rubella-IgM. SPSS version 20 was used to analyze the data, and regression analysis was also performed. Out of 156 newborns, 2 [1.3 %; 95 % CI: 0.0–3.8] were positive for CMV—IgM and no single rubella was detected. Association was not computed between risk related variables and cytomegalovirus infected newborns due to the low positivity rate. Multiple independent predictors were found between maternal CMV-IgM and Obstetrical characteristics. Cytomegalovirus—IgM was significantly isolated from mothers with history of transfusion (25.0 %, OR 0.09, 95 % CI 0.0–0.3, P = 0.006), history of abortion (OR 0.02, 95 % CI 0.0–0.6, P = 0.023), HIV sero-status (OR 5.0, 95 % CI 1.5–15.8, P = 0.034), and multi parity (OR 0.08, 95 % CI 0.01–0.7, P = 0.022). Conclusion Although low congenital CMV and no Rubella are reported among newborns, more effort is needed to screen for congenital infectious viral disease as well as usage of advanced techniques should be taken into consideration. Electronic supplementary material The online version of this article (doi:10.1186/s13104-016-2274-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yeshwondm Mamuye
- Department of Microbiology, Immunology and Parasitology, St.Paul's Hospital Millennium Medical College, P.O.Box 1271, Addis Ababa, Ethiopia.
| | - Balkachew Nigatu
- Department of Obstetrics & Gynecology, St.Paul's Hospital Millennium Medical College, P.O.Box 1271, Addis Ababa, Ethiopia
| | - Delayehu Bekele
- Department of Obstetrics & Gynecology, St.Paul's Hospital Millennium Medical College, P.O.Box 1271, Addis Ababa, Ethiopia
| | - Mekonen Getahun
- Ethiopian Public Health Institute (EPHI), Addis Ababa, Ethiopia
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Correa C, Kourí V, Pérez L, Soto Y, Limia C. Diagnosis, gB genotype distribution and viral load of symptomatic congenitally infected CMV patients in Cuba. J Perinatol 2016; 36:837-42. [PMID: 27309627 DOI: 10.1038/jp.2016.95] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 04/08/2016] [Accepted: 05/11/2016] [Indexed: 11/09/2022]
Abstract
OBJECTIVE Cytomegalovirus (CMV) is the leading cause of viral congenital infection. Some viral factors have been proposed to be CMV pathogenicity markers. The objective of this study was to investigate the frequency of congenital CMV infection in symptomatic patients and the possible association with the CMV glycoprotein B (gB) genotype and viral load. STUDY DESIGN A total of 361 newborns (NB) and 158 pregnant women (PW) with clinically suspected CMV infection were enrolled. Studied samples included urine, saliva, serum, vaginal swabs and amniotic fluid. CMV infection was diagnosed by multiplex nested PCR. CMV gB genotyping was performed on infected samples, followed by viral load determination. RESULTS Overall, 18.7% of the tested patients were positive for CMV infection, 19.7% of NB were congenitally infected and 16.5% of PW showed active CMV infection. gB-2 was the most prevalent genotype detected (39/97 patients). gB CMV mixed infections were detected in 12 patients. gB-2 was associated with mono-infections (P<0.01). Mixed infections showed higher levels of viral load compared with gB mono-infection (P=0.03). Hepatomegaly, splenomegaly, jaundice, sepsis-like syndrome and malformations were the most prevalent clinical findings. gB-4 was more frequently associated with sepsis-like syndrome than other gB genotypes (P=0.04, odds ratio=4.3, confidence interval: 0.9 to 21.6). The difference in medians of CMV load was statistically significant among patients presenting different clinical signs (P=0.04). CONCLUSIONS This study showed that CMV is a frequent cause of congenital infection in symptomatic Cuban patients. Despite gB2 being the most frequently detected, gB-4 was the only genotype associated with clinical features (sepsis-like syndrome in NB). No other associations among specific genotypes and clinical characteristics were found. Further studies are needed to clarify the role that viral load and genotype play in the outcome of congenital infection.
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Affiliation(s)
- C Correa
- Sexually Transmitted Diseases Laboratory, Virology Department, Institute of Tropical Medicine 'Pedro Kourí', Havana, Cuba
| | - V Kourí
- Sexually Transmitted Diseases Laboratory, Virology Department, Institute of Tropical Medicine 'Pedro Kourí', Havana, Cuba
| | - L Pérez
- Sexually Transmitted Diseases Laboratory, Virology Department, Institute of Tropical Medicine 'Pedro Kourí', Havana, Cuba
| | - Y Soto
- Sexually Transmitted Diseases Laboratory, Virology Department, Institute of Tropical Medicine 'Pedro Kourí', Havana, Cuba
| | - C Limia
- Sexually Transmitted Diseases Laboratory, Virology Department, Institute of Tropical Medicine 'Pedro Kourí', Havana, Cuba
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Choudhary A, Pati SK, Patro RK, Deorari AK, Dar L. Comparison of conventional, immunological and molecular techniques for the diagnosis of symptomatic congenital human cytomegalovirus infection in neonates and infants. Indian J Med Microbiol 2015; 33 Suppl:15-9. [PMID: 25657137 DOI: 10.4103/0255-0857.150874] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
PURPOSE Human cytomegalovirus (HCMV) is the commonest pathogen causing congenital infection globally. The diagnosis of congenital infection is based either on viral isolation (in cell culture) or demonstration of HCMV DNA from the urine. Saliva is also being used as an alternative sample to urine for the same. The objective of this study was to compare the following assays-polymerase chain reaction (PCR) from urine, saliva and blood, serology (anti-HCMV IgM) and antigen detection (HCMV pp65 antigenaemia) for the diagnosis of congenital HCMV infection. MATERIALS AND METHODS Urine and blood samples were collected from 31 infants (median age: 13 weeks) with suspected HCMV infection. For 18 infants, additional saliva samples were collected and all the above assays were compared. RESULTS PCR for HCMV DNA from urine and anti-HCMV IgM were performed for all 31 infants. Of these, 22 (70.9%) were positive for both assays. In 18 (of the 22) infants positive by both assays, PCR for HCMV DNA from saliva was positive in all 18 (100%), PCR from blood in 7/18 (38.8%) and HCMV pp65 antigenaemia only in 1/18 (5.5%) of the infants. CONCLUSION Detection of HCMV DNA in urine combined with anti-HCMV IgM are suitable assays to diagnose HCMV infection in infants. Both PCR from the blood and HCMV pp65 antigenaemia lack sensitivity in infants. Salivary PCR combines convenience with high sensitivity and can substitute PCR from urine, especially in the outpatient and field settings. To the best of our knowledge, this is the first study from India to evaluate salivary PCR for the diagnosis of congenital HCMV infection.
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Affiliation(s)
| | | | | | | | - L Dar
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India
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Liu Z, Zhang P, Tang S, He X, Zhang R, Wang X, Yuan Z, Tan J, Peng B, Liu E, Fu Z, Zou L. Urine real-time polymerase chain reaction detection for children virus pneumonia with acute human cytomegalovirus infection. BMC Infect Dis 2014; 14:245. [PMID: 24884393 PMCID: PMC4024271 DOI: 10.1186/1471-2334-14-245] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2013] [Accepted: 04/28/2014] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Human cytomegalovirus (HCMV) is an important pathogen of viral pneumonia in children. The diagnosis of acute HCMV infection is complicated and difficult. METHODS Clinical and laboratory data of 6063 hospitalized children with respiratory infection and 509 with respiratory virus infection alone were retrospectively analyzed. Urine and respiratory specimens of 186 hospitalized children with pneumonia were also prospectively collected. Real-time polymerase chain reaction (PCR) and a chemiluminescent assay were used to detect HCMV DNA copy number, the pp65 gene, and HCMV IgM. RESULTS The patients with respiratory virus infection alone and those with pulmonary HCMV infection (n = 422) were mostly children aged <6 months old (82.91%, 422/509). The accuracy of urine HCMV DNA (82.32%) was higher than that of HCMV IgM (67.78%), indicating that PCR of urine samples is suitable for determining pediatric acute pulmonary HCMV infection. There was no significant difference in detecting HCMV DNA or the pp65 gene between urinary and respiratory specimens (P > 0.05) in 186 pediatric pneumonia cases. The accuracy of the pp65 gene measured in urine for determining acute pulmonary HCMV infection was the highest (93.01%). CONCLUSIONS Our study shows a novel method for investigating acute pulmonary HCMV infection in children by using real-time PCR and non-invasive samples. This study also highlights the superiority and potential use of the pp65 gene as an important target for the diagnosis of acute pulmonary HCMV infection.
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Affiliation(s)
- Zhidai Liu
- Center for Clinical Molecular Medicine, Children’s Hospital, Chongqing Medical University, 136 Zhongshan Er Road, Yuzhong District, Chongqing 400014, China
- Ministry of Education Key Laboratory of Development and Disorders, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China
- Key Laboratory of Pediatrics in Chongqing, Children’s Hospital, Chongqing Medical University, Chongqing, China
| | - Penghui Zhang
- Center for Clinical Laboratory, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China
- Ministry of Education Key Laboratory of Development and Disorders, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China
- Key Laboratory of Pediatrics in Chongqing, Children’s Hospital, Chongqing Medical University, Chongqing, China
| | - Shi Tang
- Center for Clinical Molecular Medicine, Children’s Hospital, Chongqing Medical University, 136 Zhongshan Er Road, Yuzhong District, Chongqing 400014, China
- Ministry of Education Key Laboratory of Development and Disorders, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China
- Key Laboratory of Pediatrics in Chongqing, Children’s Hospital, Chongqing Medical University, Chongqing, China
| | - Xiaoyan He
- Center for Clinical Molecular Medicine, Children’s Hospital, Chongqing Medical University, 136 Zhongshan Er Road, Yuzhong District, Chongqing 400014, China
- Ministry of Education Key Laboratory of Development and Disorders, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China
- Key Laboratory of Pediatrics in Chongqing, Children’s Hospital, Chongqing Medical University, Chongqing, China
| | - Rong Zhang
- Center for Clinical Molecular Medicine, Children’s Hospital, Chongqing Medical University, 136 Zhongshan Er Road, Yuzhong District, Chongqing 400014, China
- Ministry of Education Key Laboratory of Development and Disorders, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China
- Key Laboratory of Pediatrics in Chongqing, Children’s Hospital, Chongqing Medical University, Chongqing, China
| | - Xinbin Wang
- Center for Clinical Molecular Medicine, Children’s Hospital, Chongqing Medical University, 136 Zhongshan Er Road, Yuzhong District, Chongqing 400014, China
- Ministry of Education Key Laboratory of Development and Disorders, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China
- Key Laboratory of Pediatrics in Chongqing, Children’s Hospital, Chongqing Medical University, Chongqing, China
| | - Zhaojian Yuan
- Center for Clinical Molecular Medicine, Children’s Hospital, Chongqing Medical University, 136 Zhongshan Er Road, Yuzhong District, Chongqing 400014, China
- Ministry of Education Key Laboratory of Development and Disorders, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China
- Key Laboratory of Pediatrics in Chongqing, Children’s Hospital, Chongqing Medical University, Chongqing, China
| | - Junjie Tan
- Center for Clinical Molecular Medicine, Children’s Hospital, Chongqing Medical University, 136 Zhongshan Er Road, Yuzhong District, Chongqing 400014, China
- Ministry of Education Key Laboratory of Development and Disorders, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China
- Key Laboratory of Pediatrics in Chongqing, Children’s Hospital, Chongqing Medical University, Chongqing, China
| | - Bin Peng
- Department of Health Statistics, School of Public Health, Chongqing Medical University, Yuzhong District, Chongqing, China
| | - Enmei Liu
- Department of Respiratory Medicine, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China
- Ministry of Education Key Laboratory of Development and Disorders, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China
- Key Laboratory of Pediatrics in Chongqing, Children’s Hospital, Chongqing Medical University, Chongqing, China
| | - Zhou Fu
- Department of Respiratory Medicine, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China
- Ministry of Education Key Laboratory of Development and Disorders, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China
- Key Laboratory of Pediatrics in Chongqing, Children’s Hospital, Chongqing Medical University, Chongqing, China
| | - Lin Zou
- Center for Clinical Molecular Medicine, Children’s Hospital, Chongqing Medical University, 136 Zhongshan Er Road, Yuzhong District, Chongqing 400014, China
- Ministry of Education Key Laboratory of Development and Disorders, Children’s Hospital, Chongqing Medical University, Yuzhong District, Chongqing, China
- Key Laboratory of Pediatrics in Chongqing, Children’s Hospital, Chongqing Medical University, Chongqing, China
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Multiplex detection of IgM and IgG class antibodies to Toxoplasma gondii, rubella virus, and cytomegalovirus using a novel multiplex flow immunoassay. CLINICAL AND VACCINE IMMUNOLOGY : CVI 2010; 17:1734-8. [PMID: 20861325 DOI: 10.1128/cvi.00332-10] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
The goal of this study was to evaluate the BioPlex 2200 Toxoplasma, rubella, and cytomegalovirus (CMV) (ToRC) IgG and IgM multiplex immunoassays (Bio-Rad Laboratories, Hercules, CA) and compare the results to those of conventional testing by enzyme immunoassay (EIA) and enzyme-linked fluorescent assay (ELFA). Serum specimens (n = 600) submitted for routine ToRC IgG and IgM testing by EIA (SeraQuest, Doral, FL; Diamedix, Miami, FL) or ELFA (Vidas; bioMérieux, Durham, NC) were also tested by the BioPlex ToRC multiplex immunoassays. Samples showing discordant results were retested by both methods, with further discrepancies being arbitrated by a third assay. Following repeat testing, the BioPlex Toxoplasma, rubella, and CMV IgG assays demonstrated agreements of 98.7 (592/600 specimens), 93.3 (560/600 specimens), and 98.3% (590/600 specimens), respectively, while the ToRC IgM assays yielded agreements of 91.2 (547/600 specimens), 87.3 (524/600 specimens), and 95.2% (571/600 specimens), respectively. The BioPlex ToRC IgG assays provided results comparable to EIA/ELFA results, with kappa coefficients showing near-perfect agreement for the Toxoplasma (κ = 0.94) and CMV (κ = 0.97) IgG assays and substantial agreement for the rubella IgG assay (κ = 0.66). The BioPlex ToRC IgM assays showed lower specificity with only slight agreement for Toxoplasma IgM (κ = 0.07), poor agreement for rubella IgM (κ = -0.03), and moderate agreement for CMV IgM (κ = 0.55). Both the BioPlex IgG and IgM assays reduced turnaround time (1.7 h versus 5.5 h by EIA/ELFA for 100 specimens) and eliminated the necessity to manually pipette or aliquot specimens prior to testing.
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