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"Cytomegalovirus (CMV) is a double-stranded DNA virus and a member of the Herpesviridae family. Cytomegalo- virus infection is one of the important causes of mortality and morbidity in immunocompromised patients. This is a case report of 72 year-old immunocompromised male patient with worsening cough needing an intubation despite previous adequate antibiotic administration. Further examination showed positive CMV infection. The patient showed improvement after administration of ganciclovir."

"BackgroundProdromal factors of Guillain-Barre syndrome (GBS) are often associated with previous viral infection (60%). The ailment supported by the acquired immunomediated disorder concept. Viral hepatitis is very rarely found in GBS, preceded by cytomegalovirus (15-18%), Campylobacter jejuni (28%), and Epstein-Barr virus (5%). There is no specific etiology of GBS because those viruses usually appear sporadically (subclinically). All hepatitis virus infection can cause neurological complications, including GBS.Case ReportWe report two cases of hepatitis A virus infection (HAV) in GBS patients in Dr. Sardjito General Hospital during 5 years of observation (1996-2000) from 92 GBS patients. The diagnosis of HAV was based on more than 2 times increment of transaminase enzyme, positive IgM anti HAV, negative HbsAg, and negative IgM ami HCV. The diagnosis of GBS was based on clinical symptoms of acute generalized paralysis, cerebrospinal fluid examination, and electromyelography. In both cases, sub-clinical and sporadic symptoms appeared several days before paralysis, which makes it more likely that the prodromal period of GBS occurred at the same time of HAV incubation period.DiscussionThe incidence of HAV in GBS patients during 5 years of observation was 2%. This corresponds with the case reported by Verona et al, 1996 and Pelletier et al, 1985, i.e. the presence of peripheral neuropathy (n. facialis and n. occulomotorius). Possible alternative pathways for hepatitis virus complicating as GBS are perivascular and endometrial peripheral nerve infiltration by mononuclear cells, T cell sensitization, stimulation of IL-2 growth factor surface receptor, and B cell stimulation. All of the conditions mentioned above causes necrotizing arteritis, vascular occlusion, and at the end, segmental demyelinization. Hepatitis virus may replicate in the central nervous system or peripheral nervous system, subsequently developing into multiple neuropathy disorder and poly arteritis.ConclusionThe diagnoses of HAV and GBS in both cases were established. HAV is one of several viruses that may trigger GBS. In both cases, HAV infection was sub-clinical and sporadic. Symptoms of hepatitis infection subsided along with improvements in the patient's neurological status. Acute viral hepatitis has a wide clinical spectrum and laboratory manifestation that is in accordance with the severity, varying from unclear symptom (anicteric) to jaundice. Acute hepatitis A, B, C infections have the same symptoms in general. However, hepatitis B and C tend to be more severe. The mildest symptoms are transaminase enzyme level increment, no jaundice, gastrointestinal symptoms, flu-like symptoms, and sometimes it can not be diagnosed. The more severe symptoms are jaundice with obvious generalized symptoms.' The incidence of hepatitis A is difficult to be determined accurately because of its characters, i.e. sporadic, endemic, and has a high rate of asymptomatic infection.23-4"

"ABSTRAKLatar belakang. Infeksi Cytomegalovirus (CMV) kongenital merupakan faktor non genetik yang paling sering menjadi penyebab terjadinya ketulian sensorineural pada bayi dan anak. Infeksi CMV dapat memberikan tanda dan gejala namun dapat juga tidak memberikan gejala pada yang terinfeksi. Ketulian akibat infeksi CMV kongenital tidak memiliki konfigurasi patognomik sehingga penelitian terhadap infeksi CMV kongenital pada pendengaran masih sangat diperlukan. Pengetahuan tentang ketulian akibat infeksi CMV kongenital di negara-negara luar yang semakin berkembang membuat peneliti ingin mengetahui bagaimana gambaran gangguan pendengaran anak dengan infeksi CMV kongenital di Indonesia, khususnya RS Cipto Mangunkusumo. Tujuan. Mengetahui gambaran gangguan pendengaran pada anak usia 0-5 tahun yang mengalami infeksi CMV kongenital berdasarkan pemeriksaan DPOAE dan BERA click. Metode. Penelitian cross sectional ini dilakukan di RSUPN Cipto Mangunkusumo pada bulan November 2015-Mei 2016 pada 27 subjek anak usia 0-5 tahun yang telah didiagnosa terinfeksi CMV kongenital. Hasil. Gambaran gangguan fungsi pendengaran pada subjek anak usia 0-5 tahun dengan infeksi CMV kongenital berdasarkan pemeriksaan DPOAE dan BERA click pada unit telinga adalah tuli sensorineural sebanyak 58,0%. Didapatkan hubungan yang bermakna secara statistik (p = 0,002) antara keterlambatan tumbuh kembang dengan terjadinya tuli sensorineural. Keterlambatan tumbuh kembang memiliki risiko 6,57 (CI 95%; 1,88 – 22,87) kali lebih besar dibandingkan pasien dengan tumbuh kembang normal untuk mengalami gangguan pendengaran sensorineural.

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ABSTRACTBackground. Congenital cytomegalovirus (CMV) infection is a non genetical factor that is most commonly found asthe etiology of sensorineural hearing loss in infants and children. CMV does not always cause signs and symptoms.Hearing loss caused by CMV infection does not have a patognomonic configuration hence further research is needed. The development on the knowledge on hearing loss caused by congenital CMV infection in foreign countriesis the reason the author decide to investigate on the profile of hearing impairment in children with congenital CMV infection in Indonesia, especially in Cipto Mangunkusumo Hospital. Purpose. To know the profile of hearing impairment in children age 0-5 years old with congenital CMV infection based on DPOAE and BERA click. Methods.This cross-sectional study was conducted in Cipto Mangunkusum Hospital since November 2015-May 2016 in 27 subjects, children age 0-5 years old with congenital CMV infection. Results.Hearing impairment in subjects children age 0-5 years old with congenital CMV inefection, based on DPOAE and BERA click on ear unitsis 58,0% with sensorineural hearing loss. There is a significant relationship (p=0,002) between developmental delay and the incidence of sensorineural hearing loss. Developmental delay has a 6,57 times (CI 95%; 1,88 – 22,87) higher the risk for subjects to experience sensorineural hearing loss compared to normal development.;"

"Cytomegalovirus (CMV) merupakan suatu virus DNA rantai ganda, yang termasuk dalam famili Herpesviridae. Infeksi CMV merupakan salah satu penyebab penting mortalitas dan morbiditas pada pasien-pasien imunokompromais. Tulisan ini melaporkan kasus seorang pasien pria imunokompromais berusia 72 tahun dengan batuk yang semakin memburuk hingga perlu dilakukan intubasi, meskipun sebelumnya telah diberikan terapi antibiotik yang adekuat. Pemeriksaan lebih lanjut menunjukkan adanya positif infeksi CMV. Pasien menunjukkan adanya perbaikan setelah pemberian ganciclovir."

"Latar Belakang: Infeksi sitomegalovirus (CMV) telah menjadi masalah besar secara global dengan prevalens yang tinggi. Demam neutropenia merupakan kegawatdaruratan anak di bidang onkologi karena dapat meningkatkan morbiditas dan mortalitas, salah satu penyebabnya yaitu infeksi CMV. Mengingat tingginya seroprevalens CMV di Indonesia yang dapat meningkatkan angka kematian pasien keganasan, maka penting untuk memahami profil klinis, laboratoris, dan tata laksana infeksi CMV pada demam neutropenia. Tujuan: Untuk mengetahui prevalens, karakteristik klinis, laboratoris dan tata laksana infeksi CMV pada pasien anak dengan demam neutropenia karena keganasan. Metode: Penelitian ini merupakan uji observasional secara prospektif. Subyek yang diteliti adalah seluruh pasien demam neutropenia usia 1 bulan-18 tahun yang dirawat di bangsal anak Rumah Sakit Cipto Mangunkusumo, Jakarta pada bulan Januari sampai dengan Mei 2024. Hasil: Terdapat 89 episode demam neutropenia yang memenuhi kriteria inklusi dan eksklusi, yang terjadi pada 71 pasien anak dengan median usia 6 tahun (5 bulan-16 tahun), lelaki 56,3%, dan tumor padat 53,5%. Kultur steril terbanyak yaitu darah (78,3%) dan urin (65,2%), dengan kultur positif terbanyak yaitu feses (100%), darah (21,7%), urin (34,8%), dan sputum (100%). Dari kultur yang positif, proporsi kuman terbanyak adalah Klebsiella pneumoniae (29%) dengan sensitivitas antibiotik tertinggi yaitu lini 1 gentamisin (50%), lini 2 sefoperazon sulbaktam (55,5%), dan lini 3 imipenem (72,2%). Terdapat 2 subyek dengan infeksi CMV berdasarkan PCR CMV dan peningkatan IgG 4 kali lipat dalam 4 minggu. Karekteristik klinis yang ditemukan yaitu demam neutropenia episode kedua, durasi demam 1,5 hari, suhu puncak demam 39,45oC, diare, muntah, pucat, dan perdarahan. Kedua subyek dengan status gizi baik. Karakteristik laboratoris yang ditemukan yaitu pansitopenia, peningkatan CRP, dan kultur yang negatif. Karakteristik tata laksana yang ditemukan yaitu pemberian antibiotik empiris, antijamur, dan antivirus valgansiklovir selama 14 hari. Kesimpulan: Prevalens infeksi CMV pada anak dengan demam neutropenia karena keganasan di RSCM sebesar 2,2%, dengan karakteristik klinis demam neutropenia episode kedua, durasi demam 1,5 hari, suhu puncak 39,45oC, gejala diare, muntah, pucat, dan perdarahan. Tidak terdapat karakteristik laboratoris dan tata laksana, tetapi ditemukan pansitopenia, peningkatan CRP, kultur negatif, dan pemberian valgansiklovir selama 14 hari. Hasil tambahan berupa proporsi kuman tertinggi pada pasien demam neutropenia yaitu Klebsiella pneumoniae dengan sensitivitas antibiotik tertinggi yaitu sefoperazon sulbaktam.

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Background: Cytomegalovirus (CMV) infection has become a major problem globally with high prevalence. Neutropenic fever is a pediatric oncology emergency, increasing morbidity and mortality. CMV infection should be considered as a cause of neutropenic fever. Given the high CMV seroprevalence in Indonesia, which can increase cancer patient mortality, it is crucial to understand the clinical profile, laboratory findings, and management of CMV infection in neutropenic fever. Objective: To determine the prevalence, clinical, laboratory, and management characteristics of cytomegalovirus infection in pediatric patients with neutropenic fever due to malignancy. Methods: This research was an observational study prospectively. The subjects were all neutropenic fever patients aged 1 month-18 years who were hospitalized in the Cipto Mangunkusumo Hospital (CMH) pediatric wards from January to Mei 2024. Results: There were 89 episodes of neutropenic fever that met the inclusion and exclusion criteria, found in 71 pediatric patients, with median age was 6 years old (5 months-16 years old), male 56.3%, and solid tumor 53.5%. Sterile results were found in blood (78.3%) and urine (65.2%) cultures. Positive cultures were found in feces (100%), blood (21.7%), urine (34.8%), and sputum (100%). Klebsiella pneumoniae (29%) was the highest proportion of positive cultures with the highest sensitivity antibiotic in the first line was gentamicin (50%), second line cefoperazone sulbactam (55.5%), and third line imipenem (72.2%). Two subjects were CMV infection based on PCR CMV and IgG increasing 4 times in 4 weeks. Clinical characteristics were second episode of neutropenic fever, duration of fever 1.5 days, peak temperature 39.45oC, diarrhea, vomiting, pale, bleeding, and both had good nutritional status. Laboratory characteristics showed pancytopenia, increasing CRP, and negative culture. Management characteristics included empirical antibiotic, antifungal, and antiviral valganciclovir for 14 days. Conclusion: The prevalence of CMV infection in neutropenic fever at CMH was 2.2%. Clinical characteristics were second episode of neutropenic fever, duration of fever 1.5 days, peak temperature 39.45oC, diarrhea, vomiting, pale, and bleeding. There is no laboratory and management characteristics, but found pancytopenia, increased CRP, negative culture, and administering valganciclovir for 14 days. The additional result was Klebsiella pneumoniae as the highest microbe with the highest antibiotic sensitivity was cefoperazone sulbactam."

"Pengalaman Ibu dalam Memberikan Stimulasi Tumbuh Kembang pada Anak yang Pernah Terinfeksi Cytomegalovirus Anak yang pernah terinfeksi Cytomegalovirus CMV dapat mengalami keterlambatan tumbuh kembang dan disabilitas. Penelitian ini bertujuan memperoleh gambaran pengalaman ibu dalam memberikan stimulasi tumbuh kembang pada anak yang pernah terinfeksi CMV. Metode penelitian adalah kualitatif dengan pendekatan fenomenologi melalui wawancara semi terstruktur pada tujuh ibu. Penelitian ini mengidentifikasi enam tema: anak saya istimewa, konflik tiada henti, perasaan tidak menentu, berjuang agar anak normal, tidak merasa sendirian, dan optimis perkembangan anak normal. Hasil penelitian ini terhadap pelayanan keperawatan adalah perawat dapat menginisiasi pembentukan peer group bagi ibu-ibu yang memiliki anak yang pernah terinfeksi CMV.

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Mothers rsquo Experience in Growth and Development Stimulation in Cytomegalovirus Infected Children A child that ever infected CMV may experience delayed growth and development, as well as disability. The purpose of this research was to obtain description the mothers rsquo experience in growth and development stimulation to a child that ever infected CMV. The research methodology was qualitative using phenomenology approach with semi structured interview to seven mothers. This research identified six themes my child is special, never ending conflict, uncertain feeling, struggling for normal child, not feeling alone and optimism the child development is normal. The result of this study on nursing care is nurses can initiate the formation of peer group for mothers who have children who have been infected with CMV."

"Aterosklerosis sampai saat ini merupakan penyebab utama morbiditas dan mortalitas di negara maju. Meskipun modifikasi faktor risiko di negara maju telah dapat menurunkan kekerapan aterosklerosis namun penurunan ini mulai menunjukkan grafik yang mendatar. Keadaan ini merangsang para peneliti untuk mencari faktor pajanan lingkungan termasuk faktor infeksi yang dapat mempengaruhi proses aterosklerosis. Telah dilakukan penelitian potong lintang dari bulan Maret 1998 sampai Agustus 1998 terhadap 122 orang pasien yang secara klinis menunjukkan penyakit jantung koroner yang menjalani kateterisasi jantung, terdiri dari 92 orang laki-laki dan 30 orang perempuan dengan rerata umur 55 tahun. Pasien diperiksa secara klinis dan laboratorium (gula darah, kolesterol, trigliserida dan antibodi terhadap C.pneumoniae, Cytomegalovirus dan H.pylori). Pada penelitian ini didapatkan perbedaan kadar kolesterol, trigliserida dan HDL antara kelompok stenosis koroner dan non stenosis. Sedangkan kadar antibodi C.pneumoniae, Cytomegalovirus, H.pylori tidak berbeda bermakna. Penelitian ini belum dapat menyimpulkan pengaruh antibodi terhadap aterosklerosis karena pada kelompok non stenosis tidak dapat disingkirkan kemungkinan terjadinya aterosklerosis mengingat rerata umur subyek penelitian 55 tahun. Penelitian mengenai interaksi infeksi dengan risiko tradisional serta gender dan nutrisi diperlukan untuk mendapat jawaban yang lebih jelas tentang pengaruh infeksi terhadap aterosklerosis. (Med J Indones 2002; 11: 211-4)

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Atherosclerosis is still the chief cause of morbidity and mortality in developed nations. Even though in developed nations the modification of risk factors is able to reduce the prevalence rate of atherosclerosis, such reduction is starting to slow down. Such condition has stimulated researchers to identify environmental exposure, including infection, that can influence the process of atherosclerosis. This cross sectional study was conducted from March to August 1998, on 122 patients that clinically demonstrate coronary heart disease and have underwent cardiac catheterization, 92 males and 30 females with an average age of 55 years. Patients undergo clinical and laboratory evaluation (blood glucose, cholesterol, triglyceride, and antibody for C.pneumoniae. Cytomegalovirus, and H.pylori). We found a significant difference in cholesterol, triglyceride, and HDL levels in those with coronary stenosis and those without. However, we did not find a significant difference in the levels of C.pneumoniae, Cytomegalovirus, and H.pylori antibodies. This study is unable to conclude the influence of these antibodies on atherosclerosis, since in the non-stenosis group, we cannot eliminate the possibility of atherosclerosis, since the average age of study subject is 55 years. Studies on the interaction between infection and traditional risk factors as well as gender and nutrition is needed to find a clear answer of the influence of infection in atherosclerosis. (Med J Indones 2002; 11: 211-4)"

"ABSTRAK Latar belakang : Cytomegalovirus (CMV) merupakan salah satu infeksi oportunistikpada pasien dengan sindrom immunodefisiensi (AIDS). Gejala klinis dan CT scantidak dapat menegakkan diagnosa definitif ensefalitis CMV. Oleh karena itudiperlukan uji alternatif untuk menegakkan diagnosis infeksi CMV pada pasien HIVdengan infeksi otak. Salah satu uji yang sensitif dan spesifik adalah Real TimePolymerase Chain Reaction (rPCR).Tujuan : Mendapatkan uji deteksi molekular CMV pada pasien HIV dengantersangka infeksi otak.Metode : Penelitian dilakukan dalam 3 tahap. Tahap 1 adalah optimasi konsentrasiprimer, probe, suhu annealing, volume elusi ekstraksi DNA, dan volume cetakan.Tahap 2 adalah uji spesifisitas (reaksi silang) dan uji sensitivitas (ambang batasdeteksi DNA) rPCR dan tahap 3 adalah penerapan uji rPCR yang sudah dioptimasiterhadap sampel plasma, urin, dan LCS.Hasil : Kondisi optimal uji rPCR telah diperoleh dengan konsentrasi primer danprobe 0,1 μM, dengan kondisi suhu reaksi rPCR: aktivasi enzim pada 950C selama 3menit; 45 siklus pada 950C selama 15 detik (denaturasi) dan 560C selama 1 menit(annealing dan ekstensi). Volume elusi ekstraksi DNA yang optimal untuk ketigajenis sampel (LCS, plasma dan urin) adalah 40 μL, dan volume cetakan rPCR untukLCS, plasma, dan urin, masing-masing adalah 5, 4, dan 3 μL. Uji rPCR mampumendeteksi DNA pada 50.000 jumlah kopi/mL dan tidak bereaksi silang denganStaphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus,Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacteriumtuberculosis, Candida spp, Toxoplasma gondii, EBV,HSV,dan VZV. Penerapan ujirPCR pada sampel klinis memberikan hasil negatif pada semua sampel LCS, 72,22%positif pada sampel plasma, dan 72,22% positif pada sampel urin.Kesimpulan: Telah dilakukan optimasi uji rPCR dengan minimal deteksi DNACMV 50.000 jumlah kopi/mL dan tidak bereaksi silang dengan mikroorganisme yangberpotensi menyebabkan positif palsu (false positive).ABSTRACT Background: Cytomegalovirus (CMV) is one of opportunistic infections in patientswith Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are nottypical, and CT scans can not define encephalitis CMV specifically. Therefore, it isimportant to apply an alternative assay for sensitive and specific detection of CMVinfection in HIV patients with suspected central nervous system (CNS) infections.One of the assays is real time polymerase chain reaction (rPCR).Objective: To obtain a molecular assay for detection of CMV in HIV patients withsuspect CNS infections.Methods: This study was conducted in three phases. The first is optimization ofconcentrations of primers, probe, annealing temperature, final elution of DNAextraction, and volume of PCR template. The second is determinations of sensitivity(minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR,and the third is application of the rPCR for clinical samples of plasma, urine, andliquor cerebrospinal (LCS).Results: The rPCR reaction showed optimal concentrations of primers and probe at0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing andextension). Final elution of DNA extraction was 40 μL and volume of PCR templatesfor urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimaldetection of DNA at 50,000 copies/mL and was not cross-reacted withStaphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus,Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacteriumtuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), HerpesSimplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR forclinical samples showed that the rPCR yielded 72.22% positive for plasma or urine,and negative for all LCS samples.Conclusion: The rPCR has been optimized in this study with minimal DNA detectionat 50,000 copies/mL and was not cross-reacted with other microorganisms that arepotential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patientswith Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are nottypical, and CT scans can not define encephalitis CMV specifically. Therefore, it isimportant to apply an alternative assay for sensitive and specific detection of CMVinfection in HIV patients with suspected central nervous system (CNS) infections.One of the assays is real time polymerase chain reaction (rPCR).Objective: To obtain a molecular assay for detection of CMV in HIV patients withsuspect CNS infections.Methods: This study was conducted in three phases. The first is optimization ofconcentrations of primers, probe, annealing temperature, final elution of DNAextraction, and volume of PCR template. The second is determinations of sensitivity(minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR,and the third is application of the rPCR for clinical samples of plasma, urine, andliquor cerebrospinal (LCS).Results: The rPCR reaction showed optimal concentrations of primers and probe at0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing andextension). Final elution of DNA extraction was 40 μL and volume of PCR templatesfor urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimaldetection of DNA at 50,000 copies/mL and was not cross-reacted withStaphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus,Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacteriumtuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), HerpesSimplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR forclinical samples showed that the rPCR yielded 72.22% positive for plasma or urine,and negative for all LCS samples.Conclusion: The rPCR has been optimized in this study with minimal DNA detectionat 50,000 copies/mL and was not cross-reacted with other microorganisms that arepotential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patientswith Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are nottypical, and CT scans can not define encephalitis CMV specifically. Therefore, it isimportant to apply an alternative assay for sensitive and specific detection of CMVinfection in HIV patients with suspected central nervous system (CNS) infections.One of the assays is real time polymerase chain reaction (rPCR).Objective: To obtain a molecular assay for detection of CMV in HIV patients withsuspect CNS infections.Methods: This study was conducted in three phases. The first is optimization ofconcentrations of primers, probe, annealing temperature, final elution of DNAextraction, and volume of PCR template. The second is determinations of sensitivity(minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR,and the third is application of the rPCR for clinical samples of plasma, urine, andliquor cerebrospinal (LCS).Results: The rPCR reaction showed optimal concentrations of primers and probe at0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing andextension). Final elution of DNA extraction was 40 μL and volume of PCR templatesfor urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimaldetection of DNA at 50,000 copies/mL and was not cross-reacted withStaphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus,Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacteriumtuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), HerpesSimplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR forclinical samples showed that the rPCR yielded 72.22% positive for plasma or urine,and negative for all LCS samples.Conclusion: The rPCR has been optimized in this study with minimal DNA detectionat 50,000 copies/mL and was not cross-reacted with other microorganisms that arepotential to cause false positive results.;Background: Cytomegalovirus (CMV) is one of opportunistic infections in patientswith Aquired Immunodeficiency Syndrome (AIDS). Clinical manifestations are nottypical, and CT scans can not define encephalitis CMV specifically. Therefore, it isimportant to apply an alternative assay for sensitive and specific detection of CMVinfection in HIV patients with suspected central nervous system (CNS) infections.One of the assays is real time polymerase chain reaction (rPCR).Objective: To obtain a molecular assay for detection of CMV in HIV patients withsuspect CNS infections.Methods: This study was conducted in three phases. The first is optimization ofconcentrations of primers, probe, annealing temperature, final elution of DNAextraction, and volume of PCR template. The second is determinations of sensitivity(minimal detection of DNA) and specificity (cross-reaction) of the optimized rPCR,and the third is application of the rPCR for clinical samples of plasma, urine, andliquor cerebrospinal (LCS).Results: The rPCR reaction showed optimal concentrations of primers and probe at0.1 μM, with thermal cycler: 950C for 3 min (enzyme activation), followed by 45cycles of 950C for 15 sec (denaturation) and 560C for 1 min (annealing andextension). Final elution of DNA extraction was 40 μL and volume of PCR templatesfor urine, plasma, and LCS was 3, 4, and 5 μL, respectively. The rPCR had minimaldetection of DNA at 50,000 copies/mL and was not cross-reacted withStaphylococcus aureus, Staphylococcus epidermidis, Staphylococcus saprophyticus,Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa, Mycobacteriumtuberculosis, Candida spp, Toxoplasma gondii, Epstein-Bar Virus (EBV), HerpesSimplex Virus (HSV) and Varicella Zoster Virus (VZV). Application of rPCR forclinical samples showed that the rPCR yielded 72.22% positive for plasma or urine,and negative for all LCS samples.Conclusion: The rPCR has been optimized in this study with minimal DNA detectionat 50,000 copies/mL and was not cross-reacted with other microorganisms that arepotential to cause false positive results."