Document Detail

Cytomegalovirus endomyocarditis in a transplanted heart. A case report with in situ hybridization.
MedLine Citation:
PMID:  1850589     Owner:  NLM     Status:  MEDLINE    
A 64-year-old man underwent cardiac transplantation for long-standing severe dilated cardiomyopathy. Postoperative complications included primary cytomegalovirus (CMV) infection with several episodes of moderate acute rejection and severe pneumonia. Six months after transplantation, an endomyocardial biopsy specimen revealed focal necrotizing myocarditis with intranuclear inclusions consistent with CMV. The patient subsequently developed fulminant pneumonia and died 7 months after transplantation. Postmortem examination revealed that the cause of death was acute necrotizing bronchopneumonia due to Staphylococcus aureus, with underlying CMV pneumonitis. The transplanted heart had left ventricular hypertrophy with multiple organizing myocardial infarcts, moderate coronary atherosclerosis, and organizing thrombi of the left atrium. Characteristic inclusions of CMV were identified, predominantly within endothelial cells, in the left coronary artery, left ventricular endocardium, and myocardium. With in situ hybridization, the presence of CMV was verified in the inclusions, as well as in many fibroblasts without inclusions. In situ hybridization is warranted in myocardial biopsy specimens when suspicious inclusions or infiltrates are present, to confirm CMV infection, so that appropriate therapy can be initiated.
R Millett; T Tomita; H E Marshall; L Cohen; H Hannah
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of pathology & laboratory medicine     Volume:  115     ISSN:  0003-9985     ISO Abbreviation:  Arch. Pathol. Lab. Med.     Publication Date:  1991 May 
Date Detail:
Created Date:  1991-05-30     Completed Date:  1991-05-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7607091     Medline TA:  Arch Pathol Lab Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  511-5     Citation Subset:  AIM; IM    
Department of Pathology, Menorah Medical Center, Kansas City, MO.
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MeSH Terms
Cytomegalovirus Infections*
Endocarditis / microbiology*,  pathology
Heart Transplantation*
Heart Ventricles
Middle Aged
Myocarditis / microbiology*,  pathology
Myocardium / pathology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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