Severe leukemoid reaction in a preterm infant with congenital cytomegalovirus infection.
Leukemoid reaction, defined as a total leukocyte count of >50,000/mm, is most commonly related to antenatal administration of steroids, infections, and transient myeloproliferative disorder of Down syndrome in newborns. Atypical presentations of viral infections can be a diagnostic challenge in the newborn period. Cytomegalovirus (CMV) infection causes a multisystem disease, and symptomatic infants generally present with intrauterine growth restriction, hepatosplenomegaly, cholestasis, rash, thrombocytopenia, and microcephaly. We present a case of a preterm infant with severe myeloid leukemoid reaction (leukocyte count >100,000/mm) at birth who was diagnosed with congenital CMV infection on the basis of CMV polymerase chain reaction results after the appearance of cholestasis, blueberry muffin rash, and hepatosplenomegaly.
*Neonatal Intensive Care Unit, Department of Neonatology, Etlik Zübeyde Hanim Women's Health Teaching and Research Hospital †Department of Pathology, Dr Sami Ulus Maternity and Children's Hospital, Ankara, Turkey.
Dilek U
DU
Isik
Ozge
O
Aydemir
Yusuf
Y
Kale
Husniye
H
Yucel
Ahmet Y
AY
Bas
Nihal
N
Demirel
Nilufer
N
Arda
Sema
S
Apaydin
D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000175:diagnosis*; D004279:DNA, Viral / Q000235:genetics; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007955:Leukemoid Reaction / Q000175:diagnosis*; D007958:Leukocyte Count; D008297:Male; D016133:Polymerase Chain Reaction; D011379:Prognosis
D004279:DNA, Viral