The need for a rapid and accurate viral diagnosis

Acute herpetic esophagitis--a case report

We report a case of acute herpetic esophagitis in a 33 year old man who was presumed to be immuno-compromised following prolonged steroid and cyclosporin treatment for acute rejection of a transplanted kidney. In Korea, all reported cases of herpetic esophagitis have been diagnosed in immuno-compromised and debilitated patients with a typical endoscopic appearance of ulcerating lesions. However, our patient showed multiple vesicular lesions without ulcer along the entire esophagus. The diagnosis was confirmed by colorimetric detection of herpes virus DNA using in situ hybridization. The endoscopic findings reported herein probably represent the typical early stage of acute herpetic esophagitis.

Cytomegalovirus (CMV) infections in patients receiving CMV-IgG-hyperimmunoglobulin prophylaxis after bone-marrow transplantation

Conditioning therapy with aggressive chemotherapy and irradiation induces a state of transient combined immunodeficiency in bone-marrow transplant recipients. This promotes the occurrence of severe cytomegalovirus (CMV) infections, the most frequent lethal complication after bone-marrow transplantation (BMT) at present. Forty-four BMT recipients received CMV-IgG-hyperimmunoglobulin for CMV prophylaxis intravenously. The efficacy of this prophylaxis and possible risk factors for the occurrence of CMV-induced interstitial pneumonia (IP) were analyzed. Risk factors for the promotion of a CMV-IP were: additional immunosuppressive therapy after BMT, CMV-positive serostatus of the recipient, CMV-seropositive granulocyte transfusion, CMV infection immediately prior to BMT, and HLA-haploidentical BMT. In this study the incidence of graft-versus-host disease was low and was not associated with the incidence of CMV infections. The use of T-cell-depleted grafts did not result in increased CMV infections or IP and may possibly have improved the immunological reconstitution.

Rapid method for determining the susceptibility of herpes simplex virus to acyclovir

Detecting changes in viral antigen by immunoperoxidase staining of infected cell monolayers was extended to antiviral susceptibility testing. The same endpoints of viral replication, in the presence of acyclovir, were obtained by staining monolayers by immunoperoxidase at 18 hr as by a 72-hr cytopathic effect assay. Levels of acyclovir effectively reducing viral replication by 50% when determined by estimation of reduction in replication of herpes simplex virus or derived from dose-response curves, were comparable for a number of herpes simplex virus isolates from genital sources. Overall, the immunoperoxidase staining method is more rapid, applicable to a broader range of virus groups, complements rapid detection and confirmation techniques, is readily adaptable for use in the diagnostic virology laboratory, and is potentially automatable .