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Published on: July 24, 2016
Active retinitis in an infant with postnatally acquired cytomegalovirus infection
F Piersigilli1, G Catena, M R De Gasperis
1Department of Neonatology, Bambino Gesù Children's Hospital, Rome, Italy. piersigilli@opbg.net
Insights
Postnatal cytomegalovirus (CMV) infection in infants can cause rare but severe retinitis. Early diagnosis and treatment with ganciclovir are crucial to prevent vision loss in neonates.
Area of Science:
- Ophthalmology
- Neonatology
- Infectious Diseases
Background:
- Congenital cytomegalovirus (CMV) often presents with retinitis.
- Postnatal CMV infection in immunocompetent neonates rarely causes progressive retinitis.
Observation:
- A case of an infant with postnatal CMV infection and active retinitis at 20 days of life is presented.
- The retinitis showed rapid progression.
Findings:
- Intravenous ganciclovir therapy led to prompt regression of the retinitis.
- Oral valganciclovir was administered for an additional week.
Implications:
- CMV retinitis should be considered in neonates with early postnatal CMV infection.
- Early diagnosis and treatment are vital to prevent visual impairment in affected infants.
Abstract:
Congenital cytomegalovirus (CMV) is frequently associated with active retinitis. In contrast, in the immunocompetent neonate with postnatally acquired CMV infection retinitis is rarely present and usually does not progress. We describe the case of an infant with postnatal CMV infection and active retinitis diagnosed at 20 days of life. Owing to the rapid progression of the retinitis, therapy with intravenous ganciclovir was performed, with prompt regression of the retinitis. Therapy was then continued with oral valganciclovir for one further week. Although very unusual, CMV retinitis has to be taken into consideration in neonates with early postnatally acquired CMV infection, as an early diagnosis and treatment may be crucial to avoid visual impairment.
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