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Infant death due to CMV enterocolitis

Zafer Refai1, Stuart Nicholls, Anil Garg

  • 1Trevor Mann Baby Unit, Royal county Sussex hospital, Brighton, UK. zaferrefai@hotmail.com

BMJ Case Reports
|June 19, 2012
PubMed

Insights

Cytomegalovirus (CMV) enterocolitis can be fatal in infants, even those without immune deficiencies. Early diagnosis through stool CMV PCR or biopsy is crucial for prompt management of severe infant diarrhea.

Area of Science:

  • Pediatric Gastroenterology
  • Infectious Diseases
  • Neonatal Medicine

Background:

  • Cytomegalovirus (CMV) is a common virus that can cause serious illness in infants.
  • CMV enterocolitis is a rare but severe manifestation of CMV infection.
  • Immunocompetent infants are typically at low risk for severe CMV disease.

Observation:

  • An infant presented with diarrhea and vomiting, initially improving before unexpectedly succumbing.
  • Postmortem examination confirmed cytomegalovirus enterocolitis as the cause of death.
  • This case highlights a rare presentation of CMV in an otherwise healthy infant.

Findings:

  • CMV enterocolitis can present insidiously and lead to rapid deterioration in infants.
  • Published literature reveals a paucity of cases of CMV enterocolitis in immunocompetent infants.
  • Diagnostic challenges exist in identifying CMV enterocolitis early in affected infants.

Implications:

  • Clinicians should consider CMV infection in infants with prolonged, severe diarrhea and vomiting.
  • Stool CMV PCR testing or endoscopy with biopsy may aid in early diagnosis.
  • The efficacy of antiviral treatment, such as ganciclovir, in immunocompetent infants with CMV gastrointestinal disease remains uncertain.

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