Cytomegalovirus infection other diagnostic studies

Other diagnostic studies helpful for the diagnosis of CMV infection include upper GI endoscopy, colonoscopy, serology and PCR.

• Upper GI endoscopy will reveal ulcers in the distal esophagus and diagnosis is confirmed by the demonstration of characteristic intranuclear inclusion bodies in the endothelial cells of the biopsy specimen. Culture of cytomegalovirus from the esophageal biopsy is not sufficient to confirm the diagnosis in the absence of microscopic findings as majority of patients with low CD4 counts have positive culture.^[1]
• Cytomegalovirus pneumonitis is a uncommon condition and is usually asymptomatic. It is usually diagnosed on bronchoalveolar lavage and co-exists with an underlying pulmonary infection.^[2]

• Demonstration of characteristic intranuclear inclusion bodies in the biopsy from esophagus and colon confirms the diagnosis of esophagitis and colitis.^[2]

• CMV Encephalitis
  • Cerebrospinal fluid demonstrates lymphocytic pleocytosis, low-to-normal glucose levels, and normal-to-elevated protein levels.^[2][3][4]
• CMV polyradiculomyelopathy
  • Cerebrospinal fluid analysis demonstrates neutrophilic pleocytosis, low glucose levels and elevated protein levels.^[2][3]