Histopathological detection of owl's eye inclusions is still specific for cytomegalovirus in the era of human herpesviruses 6 and 7

F M Mattes¹, J E McLaughlin², V C Emery¹, D A Clark¹ and P D Griffiths¹

¹ Department of Virology, Royal Free and University College Medical School (Royal Free Campus), Rowland Hill Street, London NW3 2PF, UK
² Department of Histopathology, Royal Free and University College Medical School (Royal Free Campus)

Correspondence to:
Dr Mattes email: mattes{at}rfhsm.ac.uk

Background—Cytomegalovirus (CMV) is the prototype member of the ß-herpesvirinae, which can cause multiple organ dysfunction in the immunocompromised host. Human herpesvirus 6 (HHV-6) and HHV-7 are newer members of the ß-herpesvirinae that can cause febrile illness in young children and are also possible pathogens in the immunocompromised patient.

Aim—CMV is detected in histopathological sections by visualisation of owl's eye inclusion bodies. The aim of this study was to quantify the relation between CMV, HHV-6, and HHV-7 viral loads and the presence of owl's eye inclusions in histological sections.

Methods—Histopathological examination of postmortem material and recording of owl's eye inclusion bodies were performed. CMV, HHV-6, and HHV-7 were detected by qualitative and quantitative polymerase chain reaction (PCR) from the same postmortem samples. Statistical analysis of the histopathological and PCR results was performed.

Results—There was a significant association between the detection of owl's eye inclusion bodies and positive CMV PCR (p < 0.001); the median CMV viral load was significantly higher in samples that were positive for owl's eye inclusions (p < 0.001). No association was found between the presence of owl's eye inclusions and HHV-6 or HHV-7 positivity.

Conclusion—Histological detection of owl's eye inclusion bodies is an insensitive but highly specific method for detecting CMV organ involvement. Owl's eye inclusion bodies are not associated with HHV-6 or HHV-7 infection.

Key Words: polymerase chain reaction • inclusion bodies • viral load

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