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Laboratory Diagnosis of Infectious Diseases Principles and Practice pp 247–260Cite as

Herpesviridae: Cytomegalovirus

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Abstract

Disease: Cytomegalic inclusion disease, congenital; cytomegalovirus mononucleosis; cytomegalovirus infection in the immunosuppressed.

Etiologic Agent: Human cytomegalovirus (HCMV), a member of the herpesvirus family.

Source: Human, by 1) direct contact, including sexual and parturition; 2) vertical; 3) breast milk; 4) blood or organ transplantation.

Clinical Manifestations: Clinical manifestations depend on the syndrome.

Congenital: hepatosplenomegaly, petechial rash, microcephaly, intracerebral calcifications, hearing loss.

Mononucleosis: fever, malaise.

Reactivation or primary infection in immunosuppressed: pneumonia, hepatitis (chemical), retinitis, encephalitis, colitis, esophagitis, adrenalitis.

Pathology: Cytomegalic cells containing a dense central intranuclear inclusion with or without associated mononuclear cell inflammatory response.

Laboratory Diagnosis: Viral isolation from urine, blood, lung, semen, or tissue. Serocon-version is diagnostic, but increase in immunoglobulin G antibody may not be significant. Immunoglobulin M antibody indicates active infection. Detection of antigen or genome may provide rapid diagnosis of infection.

Epidemiology: Worldwide, especially underdeveloped countries where infection is universal by childhood. In developed areas, approximately one-half of adults are infected. Rates of antibody prevalence increase with age and with lowering of socioeconomic status. Spread by close personal contact, including sexual. Also spread vertically, by natal exposure to infected cervix, by breast milk, and by blood transfusion or organ transplantation. Virus remains latent in host and can be reactivated, especially by immunosuppression.

Treatment: DHPG [9-(l,3-dihydroxy-2-propoxymethy)guanine] is an effective antiviral agent that suppresses CMV during treatment, but does not eradicate it.

Prevention and Control: Infection can be prevented by avoiding close personal contact (including sexual) with an actively infected individual. Transmission by blood transfusion or organ transplantation can be avoided by using blood or organs from seronegative donors.

Keywords

  • Acquire Immune Deficiency Syndrome
  • Human Cytomegalovirus
  • Cytomegalovirus Infection
  • Complement Fixation Test
  • Acquire Immune Deficiency Syndrome Patient

These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Literature Cited

  • Arvin, A. M. 1985. Cytomegaloviruses, p. 227. InE. H. Lennette (ed.), Laboratory diagnosis of viral infections. Marcel Dekker, Inc., New York.

    Google Scholar 

  • Bach, M. C., S. P. Bagwell, N. P. Knapp, K. M. Davis, and P. S. Hedstrom. 1985. 9-(l,3-Dihydroxy-2-proppoxy- methyl)guanine for cytomegalovirus infections in patients with the acquired immunodeficiency syndrome. Ann. Intern. Med. 103:381–382.

    Google Scholar 

  • Ballard, R. B., W. L. Drew, K. G. Hufnagle, and P. A. Riedel. 1979. Acquired cytomegalovirus infection in pre-term infants. Am. J. Dis. Child. 133: 482 – 485.

    PubMed  CAS  Google Scholar 

  • Barton, B. W., and J. Tobin. 1970. The effects of idoxuri- dine on the excretion of cytomegalovirus in congenital infection. Ann. N.Y. Acad. Sci. 173: 90 – 95.

    CrossRef  Google Scholar 

  • Bowden, R. A., et al. 1986. Cytomegalovirus immune globulin and seronegative blood products to prevent primary cytomegalovirus infection after bone marrow transplantation. N. Engl. J. Med. 314: 1006 – 1010.

    PubMed  CrossRef  CAS  Google Scholar 

  • Brodie, H., W. L. Drew, and S. Maayan. 1984. Prevalence of Kaposi’s sarcoma in AIDS patients reflects differences in rates of cytomegalovirus infection in high risk groups. AIDS Memorandum (NIAID) 1: 12.

    Google Scholar 

  • Carney, W. P., et al. 1981. Analysis of T lymphocyte subsets in cytomegalovirus mononucleosis. J. Immunol. 126: 2114 – 2116.

    PubMed  CAS  Google Scholar 

  • Cheeseman, S. H., et al. 1979. Controlled clinical trial of prophylactic human-leukocyte interferon in renal transplantation. N. Engl. J. Med. 300: 1345 – 1349.

    PubMed  CrossRef  CAS  Google Scholar 

  • Chien, L. T., et al. 1974. Effect of adenine arabinoside on cytomegalovirus infections. J. Infect. Dis. 130: 32 – 39.

    CrossRef  CAS  Google Scholar 

  • Chou, S., J. Dylewski, M. Gaynon, P. Egbert, and T. C. Merigan. 1984. Alpha-interferon administration in cytomegalovirus retinitis. Antimicrob. Agents Chemother. 25: 25 – 28.

    PubMed  CAS  Google Scholar 

  • Chou, S., and T. C. Merigan. 1983. Rapid detection and quantitation of human cytomegalovirus in urine through DNA hybridization. N. Engl. J. Med. 308: 921 – 925.

    PubMed  CrossRef  CAS  Google Scholar 

  • Chretien, J. H., C. G. McGinnis, and A. Muller. 1977. Venereal causes of cytomegalovirus mononucleosis. J. Am. Med. Assoc. 238: 1644 – 1645.

    CrossRef  CAS  Google Scholar 

  • Collaborative DHPG Treatment Study Group. 1986. Treatment of serious cytomegalovirus infections using 9-(l,3- dihydroxy-2-propoxymethyl)guanine in patients with AIDS and other immunodeficiencies. N. Engl. J. Med. 314: 801 – 805.

    CrossRef  Google Scholar 

  • Conchie, A. F., B. W. Barton, and J. O. Tobin. 1968. Congenital cytomegalovirus infection treated with idoxuri- dine. Br. Med. J. 4: 162 – 163.

    PubMed  CrossRef  CAS  Google Scholar 

  • Drew, W. L., and R. C. Miner. 1982. Transfusion-related cytomegalovirus infection following non-cardiac surgery. J. Am. Med. Assoc. 247: 2389 – 2391.

    CrossRef  CAS  Google Scholar 

  • Drew, W. L., L. Mintz, R. C. Miner, M. Sands, and B. Ketterer. 1981. Prevalence of cytomegalovirus infection in homosexual men. J. Infect. Dis. 143: 188 – 192.

    PubMed  CrossRef  CAS  Google Scholar 

  • Drew, W. L., E. S. Mocarski, E. Sweet, and R. C. Miner. 1984. Multiple infections with CMV in AIDS patients: Documentation by southern blot hybridization. J. Infect. Dis. 150: 952 – 953.

    PubMed  CrossRef  CAS  Google Scholar 

  • Drew, W. L., et al. 1985. Cytomegalovirus infection and abnormal T-lymphocyte subset ratios in homosexual men. Ann. Intern. Med. 103: 61 – 63.

    PubMed  CAS  Google Scholar 

  • Dworsky, M. E., K. Welch, G. Cassady, and S. Stagno. 1983. Occupational risk for primary cytomegalovirus infection among pediatric health-care workers. N. Engl. J. Med. 309: 950 – 953.

    PubMed  CrossRef  CAS  Google Scholar 

  • Elek, S. D., and H. Stern. 1974. Development of a vaccine against mental retardation caused by cytomegalovirus infection in utero. Lancet 1: 1 – 5.

    PubMed  CrossRef  CAS  Google Scholar 

  • Emanuel, D., et al. 1986. Rapid immunodiagnosis of cytomegalovirus pneumonia by bronchoalveolar lavage using human and murine monoclonal antibodies. Ann. Intern. Med. 104: 476 – 481.

    PubMed  CAS  Google Scholar 

  • Feldman, R. A. 1968. Cytomegalovirus in stored urine specimens. J. Pediatr. 73: 611 – 614.

    PubMed  CrossRef  CAS  Google Scholar 

  • Felsenstein, D., et al. 1985/ Treatment of cytomegalovirus retinitis with 9-[2-hydroxy-l-(hydroxymethyl) ethoxy- methyl]guanine. Ann. Intern. Med. 103:377–380.

    Google Scholar 

  • Fetterman, G. H., F. E. Sherman, N. S. Fabazio, and F. M. Studnicki. 1968. Generalized cytomegalic inclusion disease of the newborn: Localization of inclusions in the kidney. Arch. Pathol. 86: 86 – 94.

    PubMed  CAS  Google Scholar 

  • Field, A. K., et al. 1983. 9-([2-Hydroxy-l-(hydroxymethyl) ethoxymethyljguanine: A selective inhibitor of herpes group virus replication. Proc. Natl. Acad. Sci. USA 80:4139–4143.

    Google Scholar 

  • Follansbee, S. E., D. F. Busch, C. B. Wofsy, D. L. Coleman, J. Gullett, G. P. Aurigemma, T. Ross, W. K. Had- ley, and W. L. Drew. An outbreak of Pneumocystis carinii pneumonia in homosexual men. Ann. Intern. Med. 1982;96(part 1):705–713.

    Google Scholar 

  • Freitas, V. R., et al. 1985. Activity of 9-(l,3-dihydroxy-2- propoxymethyl)guanine compared with that of acyclovir against human, monkey and rodent cytomegalovirus. Antimicrob. Agents Chemother. 28: 240 – 245.

    CAS  Google Scholar 

  • Gleaves, C. A., T. F. Smith, E. A. Shuster, and G. R. Pearson. 1984. Rapid detection of cytomegalovirus in MRC-5 cells inoculated with urine specimens by using low-speed centrifugation and monoclonal antibody to an early antigen. J. Clin. Microbiol. 19: 917 – 919.

    PubMed  CAS  Google Scholar 

  • Goldstein, L. C., et al. 1982. Monoclonal antibodies to cytomegalovirus: Rapid identification of clinical isolates and preliminary use in diagnosis of cytomegalovirus pneumonia. Infect. Immun. 38: 273 – 281.

    PubMed  CAS  Google Scholar 

  • Goodpasture, E. W., and F. B. Talbot. 1921. Concerning the nature of “protozoan-like” cells in certain lesions of infancy. Am. J. Dis. Child. 21: 415 – 425.

    Google Scholar 

  • Griffiths, P. D., K. J. Buie, and R. B. Heath. 1980. Persistence of high titre antibodies to the early antigens of cytomegalovirus in pregnant women. Arch. Virol. 604: 303 – 309.

    CrossRef  Google Scholar 

  • Hackman, R. C., et al. 1985. Rapid diagnosis of cytomega- loviral pneumonia by tissue immunofluorescence with a murine monoclonal antibody. J. Infect. Dis. 151: 325 – 329.

    PubMed  CrossRef  CAS  Google Scholar 

  • Handsfield, H. H., et al. 1985. Cytomegalovirus infection in sex partners: Evidence for sexual transmission. J. Infect. Dis. 151: 344 – 348.

    PubMed  CrossRef  CAS  Google Scholar 

  • Haneberg, B., E. Bertnes, and G. Haukenes. 1980. Antibodies to cytomegalovirus among personnel at a children’s hospital. Acta Paediatr. Scand. 69: 407 – 409.

    PubMed  CrossRef  CAS  Google Scholar 

  • Howell, C. L., M. J. Miller, W. J. Martin. 1979. Comparison of rates of virus isolation from leukocyte populations separated from blood by conventional and Ficoll-Paque/Macrodex methods. J. Clin. Microbiol. 10: 533 – 537.

    PubMed  CAS  Google Scholar 

  • Huang, E. S., S. M. Huong, G. E. Tegtmeier, and C. A. Alford, Jr. 1980. Cytomegalovirus: Genetic variation of viral genomes. Ann. N.Y. Acad. Sci. 354: 332 – 346.

    PubMed  CrossRef  CAS  Google Scholar 

  • Jordan, M. C., W. E. Rousseau, G. R. Noble, J. A. Stewart, and T. D. Y. Chinn. 1973. Association of cervical cytomegaloviruses with venereal disease. N. Engl. J. Med. 288: 932 – 934.

    PubMed  CrossRef  CAS  Google Scholar 

  • Kangro, H. O., J. C. Booth, T. M. F. Bakir, Y. Tryhorn, and S. Sutherland. 1984. Detection of IgM antibodies against cytomegalovirus: Comparison of two radioimmunoassays, enzyme-linked immunosorbent assay and immunofluorescent antibody test. J. Med. Virol. 14: 73 – 80.

    PubMed  CrossRef  CAS  Google Scholar 

  • Katznelson, S., W. L. Drew, and L. Mintz. 1984. Efficacy of the condom as a barrier to the transmission of cytomegalovirus. J. Infect. Dis. 150: 155 – 157.

    PubMed  CrossRef  CAS  Google Scholar 

  • Keller, R., R. Peitchel, J. N. Goldman, and M. Goldman. 1976. An IgG-Fc receptor induced in cytomegalovirus- infected human fibroblasts. J. Immunol. 116: 772

    PubMed  CAS  Google Scholar 

  • Kettering, J. D., N. J. Schmidt, D. Gallo, and E. H. Lennette. 1977. Anti-complement immunofluorescence test for antibodies to human cytomegalovirus. J. Clin. Microbiol. 6: 627 – 632.

    PubMed  CAS  Google Scholar 

  • Kraybill, E. N., J. L. Sever, G. B. Avery, and N. Movassaghi. 1972. Experimental use of cytosine arabinoside in congenital cytomegalovirus infection. J. Pediatr. 80: 485 – 487.

    PubMed  CrossRef  CAS  Google Scholar 

  • Lipscheutz, B. 1921. Unterschungen uber die aetiologie der krankheiten der Herpes genitalis. Arch. Dermatol. Syph. 136: 428 – 482.

    CrossRef  Google Scholar 

  • Mar, E. C., Y. C. Cheng, and E.-S. Huang. 1983. Effect of 9-(l,3-dihydroxy-2-propoxymethyl)guanine on human cytomegalovirus replication in vitro. Antimicrob. Agents Chemother. 24: 518 – 521.

    PubMed  CAS  Google Scholar 

  • Marker, S. G., R. J. Howard, K. E. Groth, A. R. Mastry, R. L. Simmons, and H. H. Balfour. 1980. A trial of vidarabine for cytomegalovirus infection in renal transplant patients. Arch. Intern. Med. 140: 1441 – 1444.

    PubMed  CrossRef  CAS  Google Scholar 

  • Martin, W. J., and T. F. Smith. 1986. Rapid detection of cytomegalovirus in bronchoalveolar lavage specimens by a moncolonal antibody method. J. Clin. Microbiol. 23: 1006 – 1008.

    PubMed  Google Scholar 

  • Masur, H., et al. 1986. Effect of 9-(l,3-dihydroxy-2-pro- poxymethyl)guanine on serious cytomegalovirus disease in eight immunosuppressed homosexual men. Ann. Intern. Med. 104: 41 – 46.

    PubMed  CAS  Google Scholar 

  • McCracken, G. J., Jr., and J. P. Luby. 1972. Cytosine arabinoside in the treatment of congenital cytomegalic inclusion disease. J. Pediatr. 80: 488 – 495.

    PubMed  CrossRef  Google Scholar 

  • McKeating, J. A., S. Stagno, P. R. Stirk, and P. D. Griffiths. 1985. Detection of cytomegalovirus in urine samples by enzyme-linked immunosorbent assay. J. Med. Virol. 16: 367 – 373.

    PubMed  CrossRef  CAS  Google Scholar 

  • Meyers, J. D., R. McGuffin, Y. Bryson, K. Cantell, and E. Thomas. 1982. Treatment of cytomegalovirus pneumonia after marrow transplant with combined vidarabine and human leukocyte interferon. J. Infect. Dis. 146: 80 – 84.

    PubMed  CrossRef  CAS  Google Scholar 

  • Meyers, J. D., R. McGuffin, P. Neiman, J. Singer, and E. Thomas. 1980. Toxicity and efficacy of human leukocyte interferon for the treatment of cytomegalovirus pneumonia after marrow transplantation. J. Infect. Dis. 141: 555 – 562.

    PubMed  CrossRef  CAS  Google Scholar 

  • Mintz, L., W. L. Drew, R. C. Miner, and E. H. Braff. 1983. Cytomegalovirus infections in homosexual men: An epidemiological study. Ann. Intern. Med. 99: 326 – 329.

    PubMed  CAS  Google Scholar 

  • Mintz, L., R. C. Miner, and A. S. Yeager. 1980. Anticomplement immunofluorescence test that uses isolated fibroblast nuclei for detection of antibodies to human cytomegalovirus. J. Clin. Microbiol. 12: 562 – 566.

    PubMed  CAS  Google Scholar 

  • Myerson, D., R. C. Hackman, and J. D. Meyers. 1984. Diagnosis of cytomegaloviral pneumonia by in situ hybridization. J. Infect. Dis. 150: 272 – 277.

    PubMed  CrossRef  CAS  Google Scholar 

  • Peterson, P. K., et al. 1983. Risk factors in the development of cytomegalovirus-related pneumonia in renal transplant recipients. J. Infect. Dis. 148: 1121.

    PubMed  CrossRef  CAS  Google Scholar 

  • Phipps, P. H., L. Gregoire, E. Rossier, and E. Perry. 1983. Comparison of five methods of cytomegalovirus screening of blood donors. J. Clin. Microbiol. 18: 1296 – 1300.

    PubMed  CAS  Google Scholar 

  • Plotkin, S. A., W. L. Drew, D. Felsenstein, and M. S. Hirsch. 1985. Sensitivity of clinical isolates of human cytomegalovirus to 9-(l,3-dihydroxy-2-propoxymethyl)- guanine. J. Infect. Dis. 152: 833 – 834.

    PubMed  CrossRef  CAS  Google Scholar 

  • Plotkin, S. A., et al. 1984. Prevention of cytomegalovirus disease by Towne strain live attenuated vaccine, p. 271–287. InS. A. Plotkin, et al (ed.), CMV: Pathogenesis and prevention of human infection. Alan R. Liss, Inc., New York.

    Google Scholar 

  • Plotkin, S. A., and H. Stetler. 1969. Treatment of congenital cytomegalic inclusion disease with antiviral agents. Antimicrob. Agents Chemother. 9: 372 – 379.

    PubMed  CAS  Google Scholar 

  • Pollard, R. B., P. Egvert, J. Gallagher, and T. C. Merigan. 1980. Cytomegalovirus retinitis in immunosuppressed hosts. I. Natural history and effects of treatment with adenine arabinoside. Ann. Intern. Med. 93: 655 – 664.

    CAS  Google Scholar 

  • Rasmussen, L., P. T. Chen, J. G. Mullenax, and T. C. Merigan. 1984. Inhibition of human cytomegalovirus replication by 9-(l,3-dihydroxy-2-propoxymethyl)- guanine alone and in combination with human interferons. Antimicrob. Agents Chemother. 26: 441 – 445.

    PubMed  CAS  Google Scholar 

  • Reynolds, D. W., S. Stagno, and C. A. Alford. 1979. Laboratory diagnosis of cytomegalovirus infections, InE. H. Lennette and N. J. Schmidt (ed.), Diagnostic procedures for viral, rickettsial, and chlamydial infections, ed. 5. American Public Health Association, Washington, D.C.

    Google Scholar 

  • Rice, G. P. A., R. D. Schrier, and M. B. A. Oldstone. 1984. Cytomegalovirus infects human lymphocytes and monocytes: Virus expression is restricted to immediate early gene products. Proc. Natl. Acad. Sci. USA 81: 6134 – 6138.

    PubMed  CrossRef  CAS  Google Scholar 

  • Rinaldo, C. R., Jr., W. P. Carney, B. S. Richter, P. H. Black, and M. S. Hirsch. 1980. Mechanisms of immunosuppression in cytomegalovirus mononucleosis. J. Infect. Dis. 141: 488 – 495.

    PubMed  CrossRef  Google Scholar 

  • Rowe, W. P., J. W. Hartley, S. Waterman, H. C. Turner, and R. J. Huebner. 1956. Cytopathogenic agent resembling human salivary gland virus recovered from tissue cultures of human adenoids. Proc. Soc. Exp. Biol. Med. 92: 418 – 424.

    PubMed  CAS  Google Scholar 

  • Schrier, R. D., J. A. Nelson, and M. B. A. Oldstone. 1985. Detection of human cytomegalovirus in peripheral blood lymphocytes in a natural infection. Science 230: 1048 – 1051.

    PubMed  CrossRef  CAS  Google Scholar 

  • Shepp, D. H., et al. 1985. Activity of 9-[2-hydroxy-l-(hy- droxymethyl)ethoxymethyl]guanine in the treatment of cytomegalovirus pneumonia. Ann. Intern. Med. 103: 368 – 373.

    PubMed  CAS  Google Scholar 

  • Smith, M. G. 1956. Propogation in tissue cultures of a cytopathogenic virus from human salivary gland virus (SGV) disease. Proc. Soc. Exp. Biol. Med. 92: 424 – 430.

    PubMed  CAS  Google Scholar 

  • Spector, S. A., J. A. Rua, D. H. Spector, and R. McMillan. 1984. Detection of human cytomegalovirus in clinical specimens by DNA-DNA hybridization. J. Infect. Dis. 150: 121 - 126.

    PubMed  CrossRef  CAS  Google Scholar 

  • Stagno, S., et al. 1975. Cervical cytomegalovirus excretion in pregnant and nonpregnant women: Suppression in early gestation. J. Infect. Dis. 131: 522 – 527.

    PubMed  CrossRef  CAS  Google Scholar 

  • Stagno, S., et al. 1980. Comparative study of diagnostic procedures for congenital cytomegalovirus infection. Pediatrics 65: 251 – 257.

    PubMed  CAS  Google Scholar 

  • Stagno, S., D. W. Reynolds, R. F. Pass, and C. A. Alford, Jr. 1980. Breast milk and the risk of cytomegalovirus infection. N. Engl. J. Med. 302: 1073 – 1074.

    PubMed  CrossRef  CAS  Google Scholar 

  • Starr, J. G., D. Calafiore, and H. L. Casey. 1967. Experience with a human cytomegalovirus complement fixing antigen. Am. J. Epidemiol. 86: 507 – 512.

    PubMed  CAS  Google Scholar 

  • Starr, S. E., J. P. Glazer, H. M. Friedman, J. D. Farquhar, and S. A. Plotkin. 1981. Specific cellular and humoral immunity after immunization with live Towne strain cytomegalovirus vaccine. J. Infect. Dis. 143: 585 – 589.

    PubMed  CrossRef  CAS  Google Scholar 

  • The, T. H., G. Klein, and M. M. A. C. Langenhuysen. 1974. Antibody reactions to virus-specific early antigens (EA) in patients with cytomegalovirus (CMV) infection. Clin. Exp. Immunol. 16: 1 – 12.

    Google Scholar 

  • Tocci, M. J., et al. 1984. Effects of the nucleoside analogue 2;NDG on cytomegalovirus replication. Antimicrob. Agents Chemother. 25: 247 – 252.

    PubMed  CAS  Google Scholar 

  • Unger, E. R., L. R. Budgeon, D. Myerson, and D. J. Brigati. 1986. Viral diagnosis by in situ hybridization. Description of a rapid simplified colorimetric method. Am. J. Surg. Pathol. 10: 1 – 8.

    PubMed  CrossRef  CAS  Google Scholar 

  • Volpi, A., R. J. Whitley, R. Ceballos, S. Stagno, and L. Pereira. 1983. Rapid diagnosis of pneumonia due to cytomegalovirus with specific monoclonal antibodies. J. Infect. Dis. 147: 1119 – 1120.

    PubMed  CrossRef  CAS  Google Scholar 

  • Waner, J. L., T. H. Weller, and S. V. Kevy. 1973. Patterns of cytomegalovirus complement-fixing antibody activity: A longitudinal study of blood donors. J. Infect. Dis. 127: 538 – 543.

    PubMed  CrossRef  CAS  Google Scholar 

  • Weller, T. H., et al. 1971. The cytomegaloviruses: Ubiquitous agents with protean clinical manifestations (first of two parts). N. Engl. J. Med. 285: 203 – 214.

    PubMed  CrossRef  CAS  Google Scholar 

  • Weller, T. H., and J. B. Hanshaw. 1962. Virologic and clinical observations on cytomegalic inclusion disease. N. Engl. J. Med. 266: 1233 – 1244.

    PubMed  CrossRef  CAS  Google Scholar 

  • Weller, T. H., J. C. Macauley, J. M. Craig, and P. Wirth. 1957. Isolation of intranuclear inclusion producing agents from infants with illnesses resembling cytomegalic inclusion disease. Proc. Soc. Exp. Biol. Med. 94: 4 – 12.

    PubMed  Google Scholar 

  • Whitley, R., et al. 1980. Vidarabine: A preliminary review of its pharmacological properties and therapeutic use. Drugs 20: 267 – 282.

    PubMed  CrossRef  CAS  Google Scholar 

  • Yeager, A. S. 1975. Longitudinal, serological study of cytomegalovirus infections in nurses and in personnel without patient contact. J. Clin. Microbiol. 2: 448 – 452.

    PubMed  CAS  Google Scholar 

  • Yeager, A. S., et al. 1981. Prevention of transfusion-ac- quired cytomegalovirus infections in newborn infants. J. Pediatr. 98: 281 – 287.

    PubMed  CrossRef  CAS  Google Scholar 

  • Yolken, R. H. 1982. Enzyme immunoassays for the detection of infectious antigens in body fluids: Current limitations and future prospects. Rev. Infect. Dis. 4: 35 – 68.

    PubMed  CrossRef  CAS  Google Scholar 

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Drew, W.L. (1988). Herpesviridae: Cytomegalovirus. In: Laboratory Diagnosis of Infectious Diseases Principles and Practice. Springer, New York, NY. https://doi.org/10.1007/978-1-4612-3900-0_13

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