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Document 0915
DOCN M9650915
TI Clinico-pathological study of cytomegalovirus (CMV) in AIDS autopsies:
under-recognition of CMV pneumonitis and CMV adrenalitis.
DT 9505
AU Dore GJ; Marriott DJ; Duflou JA; St Vincent's Hospital, Sydney, NSW.
SO Aust N Z J Med. 1995 Oct;25(5):503-6. Unique Identifier : AIDSLINE
MED/96154418
AB BACKGROUND: Cytomegalovirus (CMV) is a common cause of morbidity in
human immunodeficiency virus (HIV) infected patients, predominantly when
severe immunosuppression has occurred. Although CMV infection of the
retina and gastrointestinal tract is well recognised as causing
substantial morbidity, the significance of infection at other sites, in
particular the lungs and adrenal glands is unclear. AIMS: To assess the
extent of CMV infection in postmortem examinations performed on
HIV-infected patients. To estimate the degree of concordance between
clinical and postmortem findings and the effect of prior diagnosis
and/or treatment of CMV infection. METHODS: The postmortem examination
findings and clinical records of 25 consecutive HIV-infected patients
who underwent a complete autopsy were examined. RESULTS: CMV infection
was demonstrated in 19 patients (76%) at postmortem examination, with
the most common sites of infection being the adrenal glands (56%) and
lungs (44%). Concordance between clinical diagnosis of CMV infection and
postmortem findings was low with only five of 19 patients (26%) having
an antemortem diagnosis. No patient with CMV infection of the lungs or
adrenal glands had a clinical diagnosis made, despite four patients
having florid CMV pneumonitis at postmortem examination; in three the
probable cause of death. CONCLUSION: CMV infection is a common
postmortem finding in HIV-infected patients but the concordance between
clinical diagnosis and autopsy findings is low. CMV appears to be a
significant pathogen in HIV-related respiratory disease.
DE Adrenal Gland Diseases/COMPLICATIONS/*VIROLOGY Adult Autopsy
AIDS-Related Opportunistic Infections/*VIROLOGY Cytomegalovirus
Infections/*COMPLICATIONS Human Male Middle Age Pneumonia,
Viral/COMPLICATIONS/*VIROLOGY JOURNAL ARTICLE
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).