David J. Morris

Ribavirin response in measles pneumonia

A 9-year-old boy with Hodgkins disease developed measles 1 month after completing eight courses of intensive anti-cancer chemotherapy. The atypical nature of the rash and the absence of Kopliks spots indicated a high risk of progression to fatal giant cell pneumonia. Seven days nebulised and intravenous ribavirin therapy produced apparent recovery. Two weeks later the child presented with measles giant cell pneumonia diagnosed on open lung biopsy. Ribavirin therapy was again successful. The role of ribavirin in the treatment of measles in immunocompromised children is discussed.

The polymerase chain reaction for detecting adenovirus DNA in formalin-fixed, paraffin-embedded tissue obtained post mortem

The polymerase chain reaction (PCR) was used to detect adenovirus DNA in formalin-fixed, paraffin-embedded tissue obtained post mortem. Adenovirus DNA was successfully amplified from specimens of lung and liver from two patients with disseminated adenovirus infection confirmed by virus isolation, electron microscopy and/or immunohistochemistry. Negative results were obtained for specimens of lung from two patients with cytomegalovirus pneumonia. The specificity of the adenovirus PCR was confirmed by means of a digoxigenin-labelled probe generated in a separate PCR. Detection of viral nucleic acid by PCR in tissues obtained post mortem has considerable diagnostic potential.

Fatal disseminated adenovirus type 2 infection following bone marrow transplantation for Hurler's syndrome: A primary infection

A 5-month-old girl given an allogeneic bone marrow transplant for Hurlers syndrome succumbed to fatal pneumonia 5 weeks after the transplant. Adenovirus type 2 was isolated from her urine before she died. Immunoperoxidase and electron microscopical studies of liver and lungs post mortem confirmed a disseminated adenovirus infection. The serological findings and the patients young age suggested that the infection was a primary one. The importance of considering exogenous sources of adenovirus infection in bone marrow transplant recipients is discussed.

Epidemiological evidence is crucial as proof of causation in cytomegalovirus disease

This review analyses the methods available to establish proof of causation in cytomegalovirus (CMV) disease. The clinical spectrum of CMV disease is discussed in the light of the crucial role of longitudinal epidemiological studies in proving causation in such disease.

Computer network for a diagnostic virology laboratory.

n Abstractn n A data base for a large diagnostic virology laboratory is described. The system uses a network of personal computers. It allows the entry, long-term storage, and subsequent retrieval of specimen and patient records (comprising personal identifiers and specimen and result information), and hard-copy results reporting. Sited entirely within the laboratory, the network is not connected to a modem. Within the laboratory there is restricted access to human immunodeficiency virus test results to guarantee patient confidentiality. Retention of a hard-copy of specimen request cards ensures the availability of the original clinical information. The data base is copied on a second file server to facilitate searches, and daily streaming onto magnetic tape provides system protection in the event of hard disc failure. Matching of old and new patient records is done by surname, date of birth, and sex, and therefore duplicate records accumulate when patient names are misspelt on specimen request forms. The system requires further development to speed searches of the data base and to achieve automatic generation of laboratory worksheets. Future goals are the replacement of hard-copy records of clinical information and hard-copy reporting with on-line access to hospital data bases and on-line requesting by and reporting to the clinician.n n