exudates and Cytomegalovirus-Infections

Topics: Cytomegalovirus Infections; Humans; Malaysia; Seroepidemiologic Studies

The objective of this study was to determine the seroprevalence of cytomegalovirus (CMV) infections through antenatal screening data and the association of this virus with obstetric complications. Serum samples from 125 apparently healthy pregnant women sent for antenatal screening from various hospitals in Malaysia between January 2007 and December 2008, were examined for CMV specific IgM and IgG antibodies using an enzyme-linked immunosorbent assay method. Of the 125 pregnant women tested, anti-CMV IgG antibody was found in 105 (84%) of the cases and anti-CMV IgM in 9 cases (7.2%). Both CMV IgM and IgG were also found in another 37 women whose serum samples were sent for investigation of various obstetric complications: 17 cases of spontaneous abortions, 15 cases of fetal anomalies detected during ultrasound examination, 1 case of incomplete abortion, 3 cases with premature delivery of infant with congenital anomalies and 1 case of infertility. Our preliminary data which only represented a small study group has shown the prevalence of CMV infection among the local population and the association of CMV in obstetric complications.

Topics: Abortion, Incomplete; Congenital Abnormalities; Cytomegalovirus Infections; Female; Fetal Death; Humans; Infertility; Malaysia; Pregnancy; Pregnancy Complications, Infectious; Premature Birth; Seroepidemiologic Studies

Cytomegalovirus (CMV) infection can present with severe manifestations that are associated with significant morbidity and mortality, especially in immunocompromised patients. CMV infections in immunocompetent patients are usually transient and do not exhibit many symptoms. However, in some patients, the manifestations can be severe. We report CMV colitis in two immunocompetent patients; one in a young man who was critically ill with septicaemia and significant non-bloody diarrhoea that responded to specific CMV treatment, and another in an elderly woman who presented with nonspecific abdominal pain and fever that resolved without specific CMV treatment.

Topics: Abdominal Pain; Adult; Biopsy; Colitis; Colon; Critical Care; Cytomegalovirus Infections; Diarrhea; Female; Humans; Inflammation; Malaysia; Male; Middle Aged; Sepsis

This study determined any clinical features which may help to differentiate biliary atresia (BA) from other causes of neonatal cholestasis (NC).. A prospective and observational study was conducted on consecutive infants with NC referred to the University of Malaya Medical Centre, Malaysia, between November 1996 and May 2004.. The 3 most common causes of cholestasis among the 146 infants with NC studied were idiopathic neonatal hepatitis (n = 63, 43%), BA (n = 35, 24%) and congenital cytomegalovirus hepatitis (n = 13, 9%). Common clinical features at presentation were jaundice (100%), hepatomegaly (95%), splenomegaly (52%) and pale stools (47%). Three clinical features noted to be sensitive for BA were the presence of acholic or variably acholic stools on admission, a liver which was firm/hard in consistency and a palpable liver of ≥4 cm (sensitivity of 77%, 80% and 94%, respectively), but the corresponding specificity was poor (51%, 65% and 39%, respectively). The stools of 2 children with BA were pigmented initially but became acholic subsequently.. We did not find any single clinical feature with sufficient sensitivity and specificity to differentiate BA from other causes of NC. Repeated inspection of stools colour is necessary as occasionally, patients with BA may have initial pigmented stools. Biochemical assessment and imaging studies are important in the assessment of any infant with NC.

Topics: Adult; Biliary Atresia; Cholestasis; Cytomegalovirus; Cytomegalovirus Infections; Diagnosis, Differential; Female; Hepatitis; Hepatomegaly; Humans; Infant, Newborn; Jaundice, Neonatal; Logistic Models; Malaysia; Male; Prospective Studies

Human cytomegalovirus (HCMV) is a species-specific DNA virus of the Herpetoviridae family. After a primary infection, HCMV persists in a latent form most probably in bone marrow progenitor cells or in peripheral blood monocytes. The virus can reactivate to result in shedding of the virus leading to virus dissemination and new infections. Immunocompromized patients are the ones most vulnerable to serious diseases occasionally acquired in blood transfusions. In a human population, HCMV seropositivity increases steadily with age to become approximately 100% in adults. This study was performed to detect seropositivity among regular blood donors in The Hospital of the Universiti Sains Malaysia, in the state of Kelantan. Using an enzyme immunoassay, it was found that 97.6% of blood donors were HCMV-positive. HCMV is highly prevalent and may be endemic in Kelantan. Hence, long-term strategies are required for the reduction of disease dissemination, and to prevent the exposure of immunocompromized patients to the virus.

Topics: Adolescent; Adult; Antibodies, Viral; Blood Donors; Cytomegalovirus; Cytomegalovirus Infections; Female; Humans; Immunoenzyme Techniques; Malaysia; Male; Middle Aged; Seroepidemiologic Studies

Regular blood transfusions for patients with thalassemia have improved their overall survival although these transfusions carry a definite risk of the transmission of certain viruses. Infection with hepatitis B virus (HBV), hepatitis C virus (HCV), cytomegalovirus (CMV) and human immunodeficiency virus (HIV) leads to complications which contribute to the morbidity and mortality of patients with thalassemia. We analyzed the blood samples taken from 85 transfusion dependent thalassemics receiving treatment at the day care center in Hospital Universiti Kebangsaan Malaysia and found that the seroprevalence rates for HBV, HCV and CMV were 2.4%, 22.4% and 91.8% respectively. None of the patients tested positive for HIV. Those positive for HBV and HCV will require further tests and treatment if chronic hepatitis is confirmed.

Topics: Adolescent; Adult; beta-Thalassemia; Child; Child Day Care Centers; Child, Preschool; Cytomegalovirus Infections; Female; Hepatitis B; Hepatitis C; Hepatitis, Viral, Human; HIV Infections; Humans; Infant; Malaysia; Male; Seroepidemiologic Studies; Transfusion Reaction

This study was carried out to determine if Japanese encephalitis virus is an important causative agent of viral encephalitis among pediatric admissions in Penang, Malaysia. 195 children with CNS symptoms and 482 children with non-specific febrile illness admitted into the Pediatric Ward of Penang Hospital during a 16 month period were entered into the study. The presence in serum of cerebrospinal fluid (csf) of Japanese encephalitis virus (JEV) specific IgM was determined by an IgM capture ELISA and cytomegalovirus (CMV) specific IgM was determined using a commercially available kit (Behringwerke AG). It was determined that 5 of 13 children with a discharge diagnosis of viral encephalitis had JEV specific IgM in csf, indicating that 38.5% of the viral encephalitis cases was due to JEV. One of the non-JEV cases was found to have mumps virus specific IgM in csf, while no etiology was determined for the other cases. It was also determined that 4 of the 195 (2.1%) cases with CNS symptoms had IgM to CMV, suggesting CMV may be an agent of encephalopathy in children in Penang. Other viruses found to be associated with CNS symptoms in children admitted into our study were measles and herpes simplex virus. A viral etiology was confirmed for 13 or the 195 cases (6.7%). We also screened 482 non-specific febrile cases for IgM to JEV and to dengue viruses and found that 2 (0.4%) had IgM specific for JEV and 9 (1.9%) had IgM specific for dengue virus.

Topics: Antibodies, Viral; Child; Child, Preschool; Cytomegalovirus Infections; Encephalitis Virus, Japanese; Encephalitis, Japanese; Encephalitis, Viral; Female; Humans; Immunoglobulin M; Malaysia; Male; Prevalence; Seroepidemiologic Studies

Topics: Cytomegalovirus Infections; Humans; Infant; Infant, Newborn; Malaysia; Prevalence

During 1984-1985, a total of 838 sera obtained from individuals of different age groups, mostly blood donors and those whose sera were received for VDRL tests and other serological investigations. The sera were titrated for complement fixing antibodies against cytomegalovirus (Ad169 strain). Three hundred and fifty two (41%) out of 838 sera showed significant antibody titre. The incidence of this virus infection varied form 26% in the age group of 11-20 years to 59% of those above 50 years of age. Geometric mean titre (GMT) was highest (22) in age groups of 11-20 years and those over 50 years indicating active viral infection in these two age groups. GMT was also significantly higher in females in all age groups except in the age group of 21-30 years and those above 50 years, indicating that active viral infection is more common in females.

Topics: Adolescent; Adult; Age Factors; Antibodies, Viral; Child; Complement Fixation Tests; Cytomegalovirus; Cytomegalovirus Infections; Female; Humans; Malaysia; Male; Middle Aged; Sex Factors

Icteric patients with clinical and biochemical evidence of liver disease, admitted into various hospitals in Malaysia, were investigated to determine the cause of their infection. Of these patients, 11.0% (16/145) were found positive for IgM anti-HAV (EIA), 4.1% (6/145) for IgM anti-HBc (EIA), 1.0% (1/102) for IgM anti-CMV (ELISA), 17.2% (16/64) for rising titres of leptospiral agglutinin, and none for heterophile antibody of EBV. Hepatitis NANB accounted for 67.9% of cases. The mean serum transaminases (ALT and AST) values in patients with hepatitis A and B were higher (more than 500IU) than in patients with leptospirosis or non-A, non-B hepatitis, whereas serum bilirubin levels were higher in patients with hepatitis A and leptospirosis than in patients with hepatitis B.

Topics: Acute Disease; Alanine Transaminase; Aspartate Aminotransferases; Cytomegalovirus Infections; Hepatitis; Hepatitis A; Hepatitis B; Hepatitis C; Humans; Infectious Mononucleosis; Leptospirosis; Malaysia

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Cytomegalovirus Infections; Female; Hepatitis A; Hepatitis B; Hepatitis C; Hepatitis, Viral, Human; Herpesvirus 4, Human; Humans; Infant, Newborn; Malaysia; Male; Middle Aged; Tumor Virus Infections

Healthy Malaysians from various parts of Peninsular Malaysia were examined for CF antibodies against cytomegalovirus (CMV) and herpes simplex virus (HSV) type 2. CMV antibodies were detected in 1114 out of 1556 persons (71.6%) and HSV antibodies were detected in 954 persons out of 1554 (61.4%). The age distribution patterns were similar for the two infections, with maximum prevalence at 5 - 14 years of age. Prevalence was higher in women than in men. There were no significant differences among the Malay, Chinese, and Indian groups of the population with respect to CMV, 72 - 78% possessing antibodies, but in the case of HSV, 76% of the Chinese had antibodies, compared with 57 - 60% of the Malays and Indians. More than 90% of newborn infants had CMV and HSV CF antibodies, confirming the highly immune status of childbearing women in Malaysia. No CMV-specific IgM was detected in the Malaysian neonates examined but this does not exclude the possibility of congenital infection.

Topics: Adolescent; Adult; Age Factors; Antibodies, Viral; Child; Child, Preschool; Cytomegalovirus Infections; Female; Herpes Simplex; Humans; Infant; Infant, Newborn; Malaysia; Male; Middle Aged; Racial Groups; Sex Factors