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Severe late-onset multisystem cytomegalovirus infection in a premature neonate previously treated for congenital infection
BACKGROUND: Cytomegalovirus is the most common pathogen causing congenital infection and can result in significant neurodevelopmental adverse outcomes. For this reason, it is the standard of care in many regions to treat congenital cytomegalovirus infection involving the brain with six weeks of ganc...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847698/ https://www.ncbi.nlm.nih.gov/pubmed/24024982 http://dx.doi.org/10.1186/1471-2431-13-142 |
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author | El-Sayed, Manal F Goldfarb, David M Fulford, Martha Pernica, Jeffrey M |
author_facet | El-Sayed, Manal F Goldfarb, David M Fulford, Martha Pernica, Jeffrey M |
author_sort | El-Sayed, Manal F |
collection | PubMed |
description | BACKGROUND: Cytomegalovirus is the most common pathogen causing congenital infection and can result in significant neurodevelopmental adverse outcomes. For this reason, it is the standard of care in many regions to treat congenital cytomegalovirus infection involving the brain with six weeks of ganciclovir. There have been no reports in the published literature of significant cytomegalovirus neonatal infection in infants previously treated for congenital infection. CASE PRESENTATION: A preterm male infant with congenital symptomatic cytomegalovirus infection was initially treated with over 8 weeks of ganciclovir between the ages of 3 and 14 weeks. At four months chronologic age, just prior to planned discharge, he developed an episode of life-threatening multisystem cytomegalovirus disease notable for severe pneumonitis, encephalitis, hepatitis, and disseminated intravascular coagulation. This disease resolved after re-treatment with a prolonged course of intravenous ganciclovir and oral valganciclovir. CONCLUSIONS: Clinicians should be aware of the possibility of recurrence of congenital cytomegalovirus infection, especially in preterm infants. Serial plasma cytomegalovirus viral load monitoring may have a role in the management of premature infants treated with ganciclovir; had the diagnosis of recrudescent cytomegalovirus infection been considered sooner, specific therapy might have been more quickly initiated and perhaps further morbidity would have been prevented. |
format | Online Article Text |
id | pubmed-3847698 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-38476982013-12-04 Severe late-onset multisystem cytomegalovirus infection in a premature neonate previously treated for congenital infection El-Sayed, Manal F Goldfarb, David M Fulford, Martha Pernica, Jeffrey M BMC Pediatr Case Report BACKGROUND: Cytomegalovirus is the most common pathogen causing congenital infection and can result in significant neurodevelopmental adverse outcomes. For this reason, it is the standard of care in many regions to treat congenital cytomegalovirus infection involving the brain with six weeks of ganciclovir. There have been no reports in the published literature of significant cytomegalovirus neonatal infection in infants previously treated for congenital infection. CASE PRESENTATION: A preterm male infant with congenital symptomatic cytomegalovirus infection was initially treated with over 8 weeks of ganciclovir between the ages of 3 and 14 weeks. At four months chronologic age, just prior to planned discharge, he developed an episode of life-threatening multisystem cytomegalovirus disease notable for severe pneumonitis, encephalitis, hepatitis, and disseminated intravascular coagulation. This disease resolved after re-treatment with a prolonged course of intravenous ganciclovir and oral valganciclovir. CONCLUSIONS: Clinicians should be aware of the possibility of recurrence of congenital cytomegalovirus infection, especially in preterm infants. Serial plasma cytomegalovirus viral load monitoring may have a role in the management of premature infants treated with ganciclovir; had the diagnosis of recrudescent cytomegalovirus infection been considered sooner, specific therapy might have been more quickly initiated and perhaps further morbidity would have been prevented. BioMed Central 2013-09-11 /pmc/articles/PMC3847698/ /pubmed/24024982 http://dx.doi.org/10.1186/1471-2431-13-142 Text en Copyright © 2013 El-Sayed et al.; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report El-Sayed, Manal F Goldfarb, David M Fulford, Martha Pernica, Jeffrey M Severe late-onset multisystem cytomegalovirus infection in a premature neonate previously treated for congenital infection |
title | Severe late-onset multisystem cytomegalovirus infection in a premature neonate previously treated for congenital infection |
title_full | Severe late-onset multisystem cytomegalovirus infection in a premature neonate previously treated for congenital infection |
title_fullStr | Severe late-onset multisystem cytomegalovirus infection in a premature neonate previously treated for congenital infection |
title_full_unstemmed | Severe late-onset multisystem cytomegalovirus infection in a premature neonate previously treated for congenital infection |
title_short | Severe late-onset multisystem cytomegalovirus infection in a premature neonate previously treated for congenital infection |
title_sort | severe late-onset multisystem cytomegalovirus infection in a premature neonate previously treated for congenital infection |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3847698/ https://www.ncbi.nlm.nih.gov/pubmed/24024982 http://dx.doi.org/10.1186/1471-2431-13-142 |
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