Cytomegalovirus infection as a possible underlying factor in neonatal surgical conditions.
BACKGROUND
The seroprevalence of cytomegalovirus (CMV) in France is about 38%. Fetal contamination during pregnancy is 40%. We report a series of gastrointestinal conditions associated with CMV in neonates.


METHODS
This is a retrospective study on neonates operated on for gastrointestinal conditions in our institution between January 1998 and December 2002. Only children with suspected CMV infection (characteristic nuclear inclusions) on pathologic examination were reviewed. We analyzed the age of onset, the clinical and radiologic presentation, and the serologic findings in mother and child.


RESULTS
The study included 3 boys and 2 girls. The average gestational age was 34.4 weeks (range, 28-39 weeks) and the average birth weight was 2364 g (range, 790-3580 g). Two infants had necrotizing enterocolitis, 2 had pathologic condition related to Meckel's diverticulum (volvulus and perforation, respectively), and 1 had distal ileal atresia. All surgical specimens showed characteristic CMV nuclear inclusions. Maternal serologic studies were positive for CMV in only 1 case with CMV IgM detected in serum. Two babies had a positive serological finding for CMV with detection of CMV IgM, and 2 had CMV isolated on urinary viral culture (one had both).


CONCLUSIONS
Cytomegalovirus is a viral agent that may be involved in surgical pathology in neonates. To confirm the causal relationship between CMV and these pathologic findings, a large-scale longitudinal prospective screening of CMV in neonates with intestinal conditions should be performed.
Bonnard
Arnaud
A
Department of Pediatric Surgery, Robert Debré Hospital, AP-HP, 75019 Paris, France. arnaud.bonnard@rdb.ap-hop-paris.fr <arnaud.bonnard@rdb.ap-hop-paris.fr>
Le Huidoux
Pascal
P
Carricaburu
Elisabeth
E
Farnoux
Caroline
C
Berrebi
Dominique
D
Aigrain
Yves
Y
de Lagausie
Pascal
P
D003586:Cytomegalovirus Infections / Q000150:complications*; D020345:Enterocolitis, Necrotizing / Q000601:surgery / Q000821:virology*; D005260:Female; D006801:Humans; D007077:Ileal Diseases / Q000209:etiology / Q000601:surgery; D007223:Infant; D007409:Intestinal Atresia / Q000601:surgery / Q000821:virology*; D007416:Intestinal Perforation / Q000209:etiology / Q000601:surgery; D045822:Intestinal Volvulus / Q000209:etiology / Q000601:surgery; D008297:Male; D008467:Meckel Diverticulum / Q000601:surgery / Q000821:virology*; D012189:Retrospective Studies