Fatal congenital cytomegalovirus infection following recurrent maternal infection after a 7-year interval.
It is generally accepted that the risk for fetal infection is greatest with maternal primary cytomegalovirus CMV infection and much less likely with recurrent infection. Here, we report a fatal case of congenital CMV infection following recurrent maternal infection after a 7-year interval. A 3-month-old female baby presented with fever, jaundice, vomiting and stopping breast-feeding. Physical examination revealed mild respiratory distress, hepatosplenomegaly, microcephaly and growth retardation. Laboratory examination included bilirubin concentrations Total: 7.17 mg/dl; conjugated 6.67 mg/dl, aspartate transaminase 141 IU, and alanine transaminase 499 IU. Enzyme-linked immunosorbent assay test results revealed + CMV IgM and + CMV IgG. She died on the 10th day of admission with the diagnosis of CMV hepatitis, pneumonia, and multi-organ failure. Nuclear and cytoplasmic inclusions were demonstrated in the lung, liver and brain on postmortem biopsy. This case highlights that the outcome of babies born to mothers with recurrent maternal CMV infection may be more severe and fatal than previously thought.
Ergun
U Guney
UG
Department of Family Medicine, Medical Faculty, Kahramanmaras Sutcu Imam University, Kahramanmaras, Turkey. guneyozer@hotmail.com
Bakaris
Sevgi
S
Ucmak
Hasan
H
Ozbek
Ayda
A
D000998:Antiviral Agents / Q000627:therapeutic use; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000188:drug therapy / Q000635:transmission*; D018450:Disease Progression; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007223:Infant; D018445:Infectious Disease Transmission, Vertical; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis*; D012008:Recurrence; D012720:Severity of Illness Index; D013997:Time Factors; D014421:Turkey
D000998:Antiviral Agents