The pathology of the temporal bones of a child with acquired cytomegalovirus infection: studies by light microscopy, immunohistochemistry and polymerase-chain reaction

Study design: The first case of an acquired cytomegalovirus (CMV) infection of the inner ear is reported in a 3-year-old girl in remission from acute lymphocytic leukemia. Methods: Horizontal sections of the temporal bones we re studied by light microscopy and immunohistological staining by avidin-bi otin-complex-technique was performed on selected archival sections. Three s ections were processed for detection of the virus genome by the polymerase chain reaction (PCR). Results: By light microscopy the epithelium of the en dolymphatic sac, the utricle and the semicircular canals showed deeply stai ned acidophilic inclusions and the stria vascularis had a loose structure e specially in the intermediate layer. The changes were limited to the non-se nsory parts of the labyrinth and no CMV type cells were observed in the org an of Corti. There was a loss of inner and outer hair cells and loss of coc hlear ganglion cells caused by either the virus or treatment with gentamici n. Standard immunohistochemistry failed to demonstrate staining with CMV an tibodies, but PCR, demonstrated CMV-DNA in one section. Conclusion: Molecul ar techniques may be able to detect acquired CMV infections in archival ped iatric bones temporal bones. The histologic findings in the labyrinth were milder, however showed some similarity to children with congenital CMV laby rinthitis. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved.