[Diagnosis of cytomegalovirus infection].

Cytomegalovirus (CMV) is a ubiquitous pathogen and causes a variety of clinical manifestations from unapparent to fatal infections. Of these variable CMV infections, intrauterine infection and infections in immunocompromised hosts are severe and often fatal. CMV infection has been diagnosed by isolation of virus and detection of more than 4-fold increase in anti-CMV antibody titer and/or CMV-specific IgM. These retrospective diagnoses, however, are not compatible to the requirement of clinical side after the appearance of anti-CMV drug, ganciclovir. The appearance of ganciclovir requires the rapid diagnosis of CMV infection which is useful for the treatment of patient. The application of monoclonal antibody and polymerase chain reaction (PCR) to CMV diagnosis made it possible to satisfy the requirement of clinical side. We developed direct immunoperoxidase method using the Fab of a monoclonal antibody against an immediate-early antigen of CMV-infected cells. Using this method, CMV infection is diagnosed within 24 hours after the collection of clinical specimens. PCR is also useful for rapid diagnosis of CMV infection. In addition, PCR can detect virus DNA sequences in cerebrospinal fluid where CMV is seldom isolated even in AIDS patients with CMV encephalitis.