The utility of clinical and radiographic features in the diagnosis of cytomegalovirus central nervous system disease in AIDS patients.

Important note: Information in this article was accurate in 1999. The state of the art may have changed since the publication date.

The utility of clinical and radiographic features in the diagnosis of cytomegalovirus central nervous system disease in AIDS patients.

Mol Diagn. 1999 Mar;4(1):37-43. Unique Identifier : AIDSLINE MED/99248376
Burke DG; Leonard DG; Imperiale TF; Valdez H; Karaman B; Shick E; Kalayjian RC; Departments of Medicine, Pathology and Radiology, University; Hospitals of Cleveland, MetroHealth Medical Center, Cleveland, OH; 44109-1998, USA.

Abstract: BACKGROUND: Polymerase chain reaction (PCR) assays of cerebrospinal fluid (CSF) for cytomegalovirus (CMV) DNA have facilitated the diagnosis of CMV-associated central nervous system disease in AIDS patients. We attempt to correlate clinical and radiographic features that are associated with CMV PCR- positivity in CSF from AIDS patients with neurologic disease. METHODS AND RESULTS: A retrospective case controlled comparison was made of CMV PCR-positive and PCR-negative patients. RESULTS: CMV PCR-positive patients were significantly more likely to have nystagmus, prior CMV retinitis, and CSF protein levels.90 mg/dL. Of patients with 0, 1, and $2 of these features, 5.6%, 55.2%, and 88.9%, respectively, were PCR-positive. Ependymal enhancement was present by magnetic resonance imaging in 9 of 12 PCR-positive, and in 8 of 30 PCR-negative patients. CONCLUSION: These clinical and radiographic features may serve as useful adjuncts toward the establishment of the diagnosis of CMV-associated neurologic disease in AIDS patients.

Keywords: JOURNAL ARTICLE Adult AIDS-Related Opportunistic Infections/*DIAGNOSIS/PATHOLOGY/ VIROLOGY Case-Control Studies Cytomegalovirus/GENETICS/ISOLATION & PURIF Cytomegalovirus Infections/*DIAGNOSIS/PATHOLOGY/VIROLOGY Cytomegalovirus Retinitis/COMPLICATIONS/DIAGNOSIS DNA, Viral/CEREBROSPINAL FLUID Encephalitis, Viral/*DIAGNOSIS/PATHOLOGY/VIROLOGY Ependyma/PATHOLOGY Human Magnetic Resonance Imaging Male Myelitis/*DIAGNOSIS/RADIOGRAPHY/VIROLOGY Nystagmus/DIAGNOSIS/ETIOLOGY Polymerase Chain Reaction Predictive Value of Tests Radiculitis/DIAGNOSIS/RADIOGRAPHY/VIROLOGY Retrospective Studies Sensitivity and Specificity Single-Blind Method
991030
A99A0899

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