Burke D G, Leonard D G, Imperiale T F, Valdez H, Karaman B, Shick E, Kalayjian R C
Departments of Medicine, Pathology and Radiology, University Hospitals of Cleveland, MetroHealth Medical Center, Cleveland, OH 44109-1998, USA.
Mol Diagn. 1999 Mar;4(1):37-43. doi: 10.1016/s1084-8592(99)80048-4.
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.
A retrospective case controlled comparison was made of CMV PCR-positive and PCR-negative patients.
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.
These clinical and radiographic features may serve as useful adjuncts toward the establishment of the diagnosis of CMV-associated neurologic disease in AIDS patients.
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