ABSTRACT
BACKGROUND: Virus investigation, specially cytomegalovirus (CMV), in blood has increased such that the capacity of hospitalary laboratories is threatened with collapse. The causal agents of viremia are analyzed being correlated with the clinical symptoms and underlying disease to establish the selection criteria of patients for virologic study. METHODS: Two thousand six hundred nineteen patients suspected of having viral infection, fundamentally by CMV were studied over 6 years by 4,394 blood samples. Of these patients 1,646 were immunosuppressed, 824 were considered immunocompetent and this data was unknown in 149 patients. The leukocytes were separated using standardized techniques being seeded in cell cultures (human embryo lung fibroblasts). RESULTS: Three hundred forty-seven specimens corresponding to 242 patients were positive with isolation of the following pathogens: 327 strains of CMV, 4 enterovirus, 2 adenovirus, 1 herpes simplex virus, 1 varicella-zoster, another 5 unidentified cytopathic agents, 6 strains of toxoplasma and 1 Cryptococcus. With regard to the base disease, 302 positive samples to CMV pertained to 204 immunosuppressed patients: 103 (13.6% positives among the cases studied) AIDS or AIDS-related complex, 54 (21.3%) kidney transplant patients, 31 (24.8%) liver transplant patients, 2 (1.5%) lung transplant patients, and 2 (1.5%) bone marrow transplant patients. A non CMV microorganism was isolated in 13 samples from 12 immunosuppressed patients. Only 24 (2.5% of those studied) immunocompetent or with unknown immunity status had viremia by CMV, being detected in 25 samples. Non CMV cytopathic agents were isolated in another 7 samples from 6 patients. CONCLUSIONS: Analysis of blood cultures allows the isolation of cytomegalovirus and occasionally other unsuspected agents such as toxoplasma. This investigation is indicated in immunosuppressed patients but not in immunocompetent patients who present a febrile syndrome with no clinical suspicion of cytomegalovirus infection.
Subject(s)
Cytomegalovirus Infections/etiology , Immunocompromised Host , Immunosuppression Therapy/adverse effects , Viremia/etiology , Adult , Child , Cytomegalovirus Infections/epidemiology , Humans , Incidence , Viremia/epidemiology , Viremia/microbiologyABSTRACT
Between 1984 and 1991 enteroviral infections have been detected in a total of 530 patients. This type of infection was more frequent during the first years of life, among males and at the end of spring. The most common complaints (70% of the cases) included gastrointestinal manifestation, respiratory symptoms or febrile illness (viremia caused by enterovirus in two patients). Enterovirus was isolated in 25 patients with intussusception. Concurrent acute heart disease was diagnosed in six patients and Guillain-Barré syndrome in four. Enterovirus was isolated from the cerebrospinal fluid in 79 patients (15%), the majority of whom were infants under 2 months of age or children from 3 to 7 years old. Differences between these two age groups are discussed. Moreover, there were 16 patients with aseptic meningitis probably caused by enterovirus. In the spring of 1987, an epidemic outbreak of enteroviral meningitis was detected, particularly among infants. This outbreak coincided with others reported in different geographic areas of our country.
