Fecal Excretion of Cytomegalovirus in Disseminated Cytomegalic Inclusion Disease

Abstract

Urine and rectal cultures were obtained at monthly intervals for three to 10 months from 36 children with complement-fixing antibody to cytomegalovirus (titer, ⩾ l: 8). Thirty-two (89 %) of the patients excreted CMV in their urine, and three (8.4%) excreted the virus in their feces. Virus was found in the saliva of 13 patients (36%) and was present in saliva each time a fecal isolate was obtained. Two patients with leukemia and an infant with congenital cytomegalic inclusion disease excreted cytomegalovirus in their feces. The fecal shedding of virus was intermittent and related to disseminated cytomegalic inclusion disease in all three patients and to viremia in two patients. One patient had gastrointestinal symptoms of diarrhea, with the diagnosis confirmed pathologically by rectal mucosal biopsy. This is the first time. cytomegalovirus has been isolated from feces, and now the fecal-oral route must be considered in the spread of infection. In addition, all patients who excreted cytomegalovirus in their feces had generalized cytomegalic inclusion disease, but none of the patients excreting cytomegalovirus from other sites had evidence of disease.