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Nuclear and cytoplasmic inclusions in disseminated human cytomegalovirus infection
Abstract:
A case of disseminated human cytomegalovirus infection is described in a full-term female who expired 3 1/2 h after birth. Cytomegalic inclusions, both intranuclear and intracytoplasmic, were observed mainly in the kidneys, liver, lungs, and anterior pituitary but were not seen in the bone marrow and spleen. Whereas the nuclear inclusions consisted of an amorphous filamentous meshwork with a variable number of pleomorphic capsids, the cytoplasmic inclusions were composed of membrane-bound aggregates of mature virions with dense cores and multilayered envelopes. The complex envelopment process of cytomegalovirus appears to involve successive coats derived from the nuclear membrane and from the endoplasmic reticulum or cytoplasmic vesicles.
Insights
A severe case of disseminated human cytomegalovirus (CMV) infection in a newborn highlights the virus's rapid impact. Pathological examination revealed characteristic CMV inclusions in multiple organs, underscoring the severity of congenital CMV disease.
Area of Science:
- Virology
- Pathology
- Neonatology
Background:
- Disseminated human cytomegalovirus (CMV) infection can cause severe neonatal disease.
- Congenital CMV infection presents a significant challenge in perinatal care.
Observation:
- A full-term infant expired 3.5 hours after birth with suspected disseminated CMV.
- Autopsy revealed cytomegalic inclusions in the kidneys, liver, lungs, and anterior pituitary.
- Inclusions were absent in the bone marrow and spleen.
Findings:
- Intranuclear inclusions showed a filamentous meshwork with pleomorphic capsids.
- Intracytoplasmic inclusions contained membrane-bound, mature CMV virions with dense cores and envelopes.
- The envelopment process involved nuclear membrane and endoplasmic reticulum or cytoplasmic vesicles.
Implications:
- This case illustrates the rapid and widespread organ damage caused by congenital CMV infection.
- Understanding the CMV envelopment process is crucial for developing antiviral therapies.
- Early detection and management strategies for congenital CMV are critical for improving neonatal outcomes.