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Suspicion of transmission of West Nile virus through organ transplantation is reviewed by identification of associated blood components in persons who donated blood to the organ donor. It is concluded that organ recipients receiving immunosuppressive drugs may be at high risk for severe disease after West Nile virus infection with blood transfusion being the probable source of the West Nile virus viremia in the organ donor.

ABSTRACT: Antibody to Epstein-Barr virus (EBV) early antigen has been said to be the most specific indicator of symptomatic chronic EBV infection. We studied the clinical utility of this serologic test in the evaluation of patients with chronic fatigue. Thirty patients with chronic fatigue and highly elevated titers of antibody to early antigen (>= 1:160) were compared with 30 age- and sex-matched controls with no antibody to early antigen. There were no significant differences noted between patients and controls at the initial evaluation (symptoms, physical examination, laboratory data). Follow-up information, available for 15 matched pairs, showed no differences in outcome between patients and controls. We conclude that the antibody to EBV early antigen is not helpful in the clinical evaluation of patients with chronic fatigue.

In immunocompetent patients, Mycobacterium avium/Mycobacterium intracellulare complex (MAC) has been associated with pulmonary infection in adults, cervical lymphadenitis in children, and disseminated infection in children and adults. MAC rarely has been recognized as a cause of localized soft-tissue infection in immunocompetent hosts. Six cases of granulomatous tenosynovitis due to MAC are reported; five cases occurred after local surgical procedures, trauma, or corticosteroid injection. In four cases, cure was achieved with combined medical and surgical intervention. In these six cases and 11 previously reported cases, both males and females were affected equally, usually in the fifth to seventh decades of life, and the distal upper extremity was predominantly involved. Surgical debridement with appropriate culture was critical for diagnosis and management. Antimycobacterial chemotherapy seemed to be a beneficial adjunctive measure in most cases but was clearly necessary for cure in only a few cases. [ABSTRACT FROM PUBLISHER]

Retinitis reminiscent of the acute retinal necrosis syndrome was recognized in a patient with AIDS-related complex after he had experienced several episodes of a sacral, dermatomic zosteri-form eruption. Varicella-zoster virus (VZV) was subsequently recovered from cell culture of retinal tissue. The literature on VZV retinitis, including that on acute retinal necrosis, is reviewed. Dissemination of VZV infection in AIDS is also reviewed. Features that differentiate the findings and course of VZV retinitis in patients with AIDS from those in otherwise healthy adults are noted and related to potentially different pathogenic mechanisms. This unusual and recently recognized complication of herpesvirus infection may be promoted by AIDS-related immunosuppression. Acute retinal necrosis and other more-recently described forms of VZV retinitis, which have primarily been subjects of the ophthalmologic literature, merit the attention of clinicians and investigators of infectious diseases. [ABSTRACT FROM PUBLISHER]

The article focuses on a case of a possible hepatitis B virus (HBV) infection linked with liver transplantation reported to the U.S. Centers for Disease Control and Prevention (CDC). The donor, who was declared brain-dead due to a traumatic brain injury, was not at high risk for HBV infection based on initial evaluation. The use of nucleic acid testing (NAT) for screening to mitigate the risk for HBV transmission is tackled. Pre-transplant vaccination is recommended for further risk reduction.

Presents a letter to the editor responding to Hermann's claim that the cause of elevated antibody to Epstein-Barr virus early antigen in patients with chronic fatigue remains unexplained, published in the 'Journal of the American Medical Association'.