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Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia

Received: 12 August 2019     Accepted: 6 September 2019     Published: 23 October 2019
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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.

Published in American Journal of Pediatrics (Volume 5, Issue 4)
DOI 10.11648/j.ajp.20190504.21
Page(s) 230-233
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Human Cytomegalovirus, Herpes Viridae, Thrombocytopenia, TORCH

References
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[2] Swanson EC, Schleiss MR. Congenital cytomegalovirus infection: new prospects for prevention and therapy. Pediatric Clinics. 2013 Apr 1; 60 (2): 335-49.
[3] Schleiss MR. Acquisition of human cytomegalovirus infection in infants via breast milk: natural immunization or cause for concern? Reviews in medical virology. 2006 Mar; 16 (2): 73-82.
[4] Manicklal S, Emery VC, Lazzarotto T, et al. The ‘‘silent’’ global burden of congenital cytomegalovirus. Clin Microbiol Rev 2013; 26: 86–102.
[5] Cannon MJ, Schmid DS and Hyde TB. Review of cytomegalovirus seroprevalence and demographic characteristics associated with infection. Rev Med Virol 2010; 20: 202–213.
[6] Pass RF, Fowler KB, Boppana SB, et al. Congenital cytomegalovirus infection following first trimester maternal infection: symptoms at birth and outcome. J Clin Virol 2006; 35: 216–220.
[7] Dollard SC, Grosse SD, Ross DS. New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection. Rev Med Virol. 2007; 17 (5): 355–363. [PubMed: 17542052].
[8] Boppana SB, Pass RF, Britt WJ, et al. Symptomatic congenital cytomegalovirus infection: neonatal morbidity and mortality. Pediatr Infect Dis J. 1992; 11 (2): 93–99.
[9] Conboy TJ, Pass RF, Stagno S, et al. Early clinical manifestations and intellectual outcome in children with symptomatic congenital cytomegalovirus infection. J Pediatr. 1987; 111 (3): 343–348.
[10] Pass RF, Stagno S, Myers GJ, et al. Outcome of symptomatic congenital cytomegalovirus infection: results of long-term longitudinal follow-up. Pediatrics. 1980; 66 (5): 758–762.
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[13] Yamamoto AY, Mussi-Pinhata MM, Marin LJ, et al. Is saliva as reliable as urine for detection of cytomegalovirus DNA for neonatal screening of congenital CMV infection? Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology. 2006; 36 (3): 228–230.
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  • APA Style

    Nipun Shrestha, Bhabuk Sharma Majagaiya, Dhruba Shrestha. (2019). Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia. American Journal of Pediatrics, 5(4), 230-233. https://doi.org/10.11648/j.ajp.20190504.21

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    ACS Style

    Nipun Shrestha; Bhabuk Sharma Majagaiya; Dhruba Shrestha. Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia. Am. J. Pediatr. 2019, 5(4), 230-233. doi: 10.11648/j.ajp.20190504.21

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    AMA Style

    Nipun Shrestha, Bhabuk Sharma Majagaiya, Dhruba Shrestha. Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia. Am J Pediatr. 2019;5(4):230-233. doi: 10.11648/j.ajp.20190504.21

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  • @article{10.11648/j.ajp.20190504.21,
      author = {Nipun Shrestha and Bhabuk Sharma Majagaiya and Dhruba Shrestha},
      title = {Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia},
      journal = {American Journal of Pediatrics},
      volume = {5},
      number = {4},
      pages = {230-233},
      doi = {10.11648/j.ajp.20190504.21},
      url = {https://doi.org/10.11648/j.ajp.20190504.21},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20190504.21},
      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.},
     year = {2019}
    }
    

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  • TY  - JOUR
    T1  - Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia
    AU  - Nipun Shrestha
    AU  - Bhabuk Sharma Majagaiya
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    DO  - 10.11648/j.ajp.20190504.21
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
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    AB  - 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.
    VL  - 5
    IS  - 4
    ER  - 

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Author Information
  • Siddhi Memorial Hospital (for Women and Children), Bhaktapur, Nepal

  • Siddhi Memorial Hospital (for Women and Children), Bhaktapur, Nepal

  • Siddhi Memorial Hospital (for Women and Children), Bhaktapur, Nepal

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