Severe postnatal cytomegalovirus infection in a very premature infant.
Several studies have reported that postnatally acquired cytomegalovirus (CMV) infection can cause sepsis-like syndrome in premature infants. We here report a 622-gram birth weight male infant of 23 weeks' gestation who had sepsis-like syndrome and pneumonia. Substantial CMV loads were detected in peripheral blood cells, plasma, and urine when the patient was in crisis, but was decreased in parallel to clinical improvement without using ganciclovir. CMV DNA was not detected from his umbilical cord or Guthrie card, even by highly sensitive real-time PCR. Molecular profiles were indistinguishable between the CMV strain isolated from his urine and that from maternal breast milk, indicating postnatal acquisition of CMV through breast milk. Although he had transient hearing impairment, his neurodevelopmental outcome of 30 months of corrected age was normal. Further accumulation of clinical and virological data in postnatal CMV infection is necessary for evaluating the severity and selecting patients requiring antiviral therapy.
Takahashi
Ritsuko
R
Neonatal Intensive Care Unit in Perinatal Center, Japanese Red Cross Sendai Hospital, Sendai, Japan. ritsu@sendai.jrc.or.jp
Tagawa
Masato
M
Sanjo
Masatoshi
M
Chiba
Hiroo
H
Ito
Takeshi
T
Yamada
Masaaki
M
Nakae
Shingi
S
Suzuki
Akira
A
Nishimura
Hidekazu
H
Naganuma
Masako
M
Tominaga
Norio
N
Moriuchi
Masako
M
Moriuchi
Hiroyuki
H
D000998:Antiviral Agents / Q000627:therapeutic use; D003587:Cytomegalovirus / Q000302:isolation & purification / Q000472:pathogenicity; D003586:Cytomegalovirus Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000635:transmission*; D005260:Female; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D008297:Male; D008895:Milk, Human / Q000821:virology*; D011247:Pregnancy; D012720:Severity of Illness Index
D000998:Antiviral Agents; D015774:Ganciclovir