Incidence of CMV Excretion

Clinical characteristics of the 115 patients are shown in Table 1. Viral shedding was found in 29 (25 percent) of 115 patients, with CMV isolated from the blood in 20, from urine in six, and from both sites in three patients. The age, type of surgery, delay between ECC and first viral cultures, and serologic status were not different between VE + and VE- patients. A significant difference was observed in the sex ratio, with 31 percent females (9/29) in VE 4- patients vs 10 percent (9/86) in VE – patients (p<0.02).

Among the 78 patients who had CMV-IgG deter­mination within 30 days following ECC, 22 (28 per­cent) had IgG titer greater than 1/8, similar in VE + patients (8/22; 36 percent) and VE – patients (14/56; 25 percent).
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FIGURE 1. Three-month distribution ofCMV

FICURE 1. Three-month distribution of CMV infection in patients with mediastinitis.

Table 2—Laboratory Abnormalities and Systemic Manifestations in Batients with Mediastinitis

Data

VE +

VE-

No. of patients

29

86

Hematologic features

Atypical lymphocytosis

Present

16 (55)t

26 (30)

>200/cu mm

9 (31)t

6(7)

Erythrocyte count x

3.34 ±0.41

3.36 ±0.51

lOVcu mm

Hemoglobin, g/dl

9.95 ±1.3

10± 1.5

WBC count
x
lOVcu mm

12.780 ±5.800

12.860 ±6.500

Lymphocyte count x

3.060 ±2.070

2.190 ±0.900

lOVcu mm

Enzymatic abnormalities,

percent of patients

Peak AST elevated

83$

47

>2 x normal

31

24

Peak ALT elevated

62

51

>2 X normal

38

31

Peak LDH elevated

97

81

>2 X normal

45t

23

Jaundice

Serum bilirubin >1.5

55

38

x
normal

Renal failure

Serum creatinine >4

55t

32

x
normal

Pulmonary impairment

Radiologic score >4/12

62

68

Figure 1 shows the three-month distribution of mediastinitis during the study. We observed no sea­sonal variations in the rate of CMV excretion, but since January 1985, there was a trend towards a higher rate of infection. The mean delay between the ECC and the first positive viral culture in the group of VE + patients was 37 ±22 days (range, 9 to 98 days), which was similar to the mean delay observed between ECC and the last negative culture in VE — patients (39 ± 25 days).
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Category: Diseases / Tags: Cardiac Surgery, Cytomegaloviral Infection, incidence, Morbidity

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