Medical image of the week: CMV cytopathic effect

Abstract

No abstract available. Article truncated at 150 words. Bronchoalveolar lavage (BAL) was performed on a 45-year old man with a history of treated mycosis fungoides and Sézary syndrome, who presented with fever and pulmonary infiltrates. BAL Papanicolaou stain (Figure 1, 400x) showed single cells (lymphocytes, arrows and alveolar macrophages, stars) and a small cluster of 3 large cells, most likely infected type II pneumocytes, with a single prominent red stained nuclear inclusion surrounded by a clear halo. Nuclear chromatin was marginated on the nuclear membrane creating this “owl’s eye” appearance. In vitro, infected cells show cytomegalovirus (CMV) virions within the nuclear inclusion (Figure 2, small black dots encircled, 8,800x) The "owl's eye" appearance (Figure 1) is the “cytopathic effect” needed to definitively diagnose active CMV infection. While cells infected with adenovirus or herpesvirus may have nuclear inclusions, the cells typically are much smaller. CMV was cultured from the BAL, and no other pathogen was identified by cytology or ...

Keywords

• cytomegalovirus
• CMV
• cytopathic effect
• owl's eye
• bronchoalveolar lavage
• nuclear inclusion
• Papanicolaou stain
• electron microscopy
• virion
• diagnosis