Abstract
Human Cytomegalovirus (CMV) is a member of Herpes viridae family, that affects most of the human population at some stage of live and is the most common congenital infection causing sensorineural hearing loss and neurodevelopmental delay in newborn. CMV infection may be acquired in a newborn congenitally or after delivery, but except for the congenital infection, other mode of infection rarely result in significant symptoms or sequel in them. Clinical findings of congenital CMV infection include IUGR, hydrops, generalized petechiae, purpura, thrombocytopenia, jaundice, hepatosplenomegaly, pneumonitis, microcephaly, periventricular calcifications, seizures, chorioretinitis, sensorineural hearing loss, bone abnormalities, abnormal dentition, and hypocalcified enamel. Here we present a case of congenital CMV infection who presented with Pneumonia with Respiratory distress and thrombocytopenia. A single, live, term, female child delivered at home developed low grade fever, cough and increased oral secretion at 28 day of life and was initially diagnosed as Pneumonia with respiratory distress with thrombocytopenia. Mother and child, both were investigated for TORCH infection which came out to be positive for CMV infection (child’s serum CMV Ab IgM 94 U/ml). Her CMV Viral Load Real Time PCR tested positive with 56380 copies/ml.
Highlights
Human Cytomegalovirus (CMV) is a member of Herpes viridae family, that affects most of the human population at some stage of live and is the most common congenital infection causing sensorineural hearing loss and neurodevelopmental delay in newborn
On arrival to our center, the child appeared sick with increased respiratory rate (70 breath/minute) and with increased respiratory effort suggested by marked subcoastal retraction and nasal flaring and decreased Peripheral capillary oxygen saturation TLC (SPO2) (70% in Room Air)
CMV infection is a global problem and seropositivity can be found in more than 45% of women of reproductive age, mainly in the developing countries. [4, 5] Transmission of CMV infection from mother to fetus can occur at any stage of pregnancy, but the severe adverse fetal outcome is seen if it is transmitted to fetus in 1st half of pregnancy
Summary
Human Cytomegalovirus (CMV) is a member of Herpes viridae family, that affects most of the human population at some stage of live and is the most common congenital infection causing sensorineural hearing loss and neurodevelopmental delay in newborn. [1] The virus is shed from infected person through saliva, blood, urine, breastmilk and genital secretion and maternal transmission to fetus can occur at any age of gestation. [2] CMV infection may be acquired in a newborn congenitally or after delivery, but except for the congenital infection, other mode of infection rarely result in significant symptoms or sequel in them. [3] Clinical findings of congenital CMV infection include IUGR, hydrops, generalized petechiae, purpura, thrombocytopenia, jaundice, hepatosplenomegaly, pneumonitis, microcephaly, periventricular calcifications, seizures, chorioretinitis, sensorineural hearing loss, bone abnormalities, abnormal dentition, and hypocalcified enamel. [2]. On arrival to our center, the child appeared sick with increased respiratory rate (70 breath/minute) and with increased respiratory effort suggested by marked subcoastal retraction and nasal flaring and decreased SPO2 (70% in Room Air) She had bilateral Basal Crepitations on chest auscultation. Her Blood reports are as follows: TLC 13200/cmm, N36%, L61%, Hb 14.9g/dl, Platelet 30000/cmm, CRP
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