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Electron Microscopy of Infectious AgentsCase 1: Cytomegalovirus (CMV) Infection in the LungCase PresentationThe patient is a 14 year old female who developed a fever and tonsilar exudate while undergoing chemotherapy for leukemia. The frozen section diagnosis of a lung biopsy was probable viral pneumonitis. Sections stained with H&E showed chronic interstitial pneumonitis. The histology favored a viral etiology, although viral inclusions were not identified. A portion of the lung biopsy was submitted for electron microscopy because electron microscopy can sometimes disclose viruses when they are either sparse in number or not readily apparent in paraffin sections. Electron MicroscopyA review of the toluidine blue sections did not show viral inclusions or other areas that were probable for viruses, so we selected an area of parenchymal thickening for thin sections. |
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 Figure 1. Magnify Image |
This is a pneumocyte that was almost totally involved with virus particles. This micrograph shows a moderately dense cluster of uncoated viral particles in the nucleus and cytoplasmic vesicles containing electron dense, coated, mature virions. | |
 Figure 2. Magnify Image |
A higher magnification shows portions of a membrane-limited vesicles with the electron dense viral cores surrounded by a fuzzy coat. The cores measure 60 nm and the coated particles measure 150 nm in diameter, which is in the Herpes virus size range. | |
| Discussion | ||
| September 1998 Case-of-the-Month | ||