Abstract

Depression of host defence mechanisms can be related to old age, underlying debilitating disease, and malnutrition. In recent years the use of immunosuppressive drugs, such as corticosteroids, antimetabolites, and alkylating agents have been attributed to acquired immune deficiency states. This problem is particularly important in patients receiving organ transplants who are maintained on immunosuppressive drugs for long periods of time. In these individuals, opportunistic infections with such uncommon low virulence agents as fungi, cytomegalovirus and pneumocystis carinii have induced fatal disease. Cytomegalic inclusion disease(CID) is encountered mainly in infancy and early childhood, particulary in prematures, who have not yet developed any immunologic resistance, and rarely in vulnerable adults. This viral infection caused by the DNA cytomegalovirus is characterized by the appearance of large(15 microns in diameter) intranuclear and smaller intracytoplasmic inclusion bodies in strikingly enlarged cells (40 microns in diameter) of many viscera. The intranuclear inclusion is characteristically surrounded by a clear halo demarcating it from the nuclear membrane. In this report two cases of CID are described. The first case developed in the course of costeroid therapy for the generalized exfoliative dermatitis, and the second case is that of a malnourished infant, who was associated with pneumocystis carinii pneumonia.