title: Life-threatening intracranial bleeding in a newborn with congenital cytomegalovirus infection: late-onset neonatal hemorrhagic disease.
abstract: The authors present a case of a 36-day-old infant with intracranial and intramuscular hemorrhage due to vitamin K deficiency bleeding, who received intramuscular vitamin K prophylaxis at birth. In this case, laboratory tests showed anemia, liver dysfunction with cholestasis, and coagulopathy, consistent with vitamin K deficiency abnormality. Serological analyses showed that cytomegalovirus immunoglobulin (Ig)M and IgG avidity were both positive. The infant was treated successfully with intravenous ganciclovir and blood products. This case suggests that it is imperative to meticulously investigate the etiology in neonates with late-onset hemorrhagic disease of the newborn. Cholestatic liver disease caused by congenital cytomegalovirus infection should be in mind in term infants who presented with late-onset hemorrhagic disease.
authors.affiliation: Department of Pediatrics, Ankara Training and Research Hospital, The Ministry of Health of Turkey, Ankara, Turkey.
authors.forename: Yildiz
authors.initials: Y
authors.lastname: Dallar
authors.forename: Ulku
authors.initials: U
authors.lastname: Tiras
authors.forename: Tulin
authors.initials: T
authors.lastname: Catakli
authors.forename: Gonul
authors.initials: G
authors.lastname: Gulal
authors.forename: Yavuz
authors.initials: Y
authors.lastname: Sayar
authors.forename: Beray
authors.initials: B
authors.lastname: Selvar
authors.forename: Bulent
authors.initials: B
authors.lastname: Alioglu
mesh_terms: D003586:Cytomegalovirus Infections / Q000150:complications* / Q000151:congenital* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D015774:Ganciclovir / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D020300:Intracranial Hemorrhages / Q000150:complications* / Q000151:congenital* / Q000175:diagnosis / Q000188:drug therapy; D011517:Prothrombin Time; D006475:Vitamin K Deficiency Bleeding / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy
chemical_list: D015774:Ganciclovir