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Progressive hearing loss following acquired cytomegalovirus infection in an immunocompromised child

Ken Kato1, Hironao Otake, Mitsuhiko Tagaya

  • 1Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, Japan. katoken@med.nagoya-u.ac.jp

American Journal of Otolaryngology
|October 23, 2012
PubMed

Insights

This case study highlights acquired cytomegalovirus (CMV) infection causing progressive hearing loss in a child with Langerhans cell histiocytosis (LCH). The findings suggest a link between CMV infection and sensorineural hearing loss in immunocompromised patients.

Area of Science:

  • Pediatric Otolaryngology
  • Infectious Diseases
  • Hematology-Oncology

Background:

  • Langerhans cell histiocytosis (LCH) is a rare clonal proliferative disorder.
  • Umbilical cord blood transfusion is a treatment for severe LCH.
  • Cytomegalovirus (CMV) infection is a common opportunistic infection in immunocompromised individuals.

Observation:

  • A 5-month-old female diagnosed with LCH received an unrelated donor umbilical cord blood transfusion at 14 months.
  • CMV infection was confirmed post-transfusion, indicating an acquired infection.
  • Progressive mixed and sensorineural hearing loss was observed starting at age 7, advancing to profound bilateral hearing loss over 3 years.

Findings:

  • Three-dimensional FLAIR MRI revealed inner ear high-intensity areas suggestive of bilateral labyrinthitis.
  • The acquired CMV infection, occurring under iatrogenic immunodeficiency, is implicated as the cause of progressive sensorineural hearing loss.
  • This case underscores the potential ototoxicity of CMV in immunocompromised pediatric patients.

Implications:

  • Highlights the importance of audiological monitoring in immunocompromised children with LCH and post-transfusion CMV infection.
  • Suggests CMV infection as a potential cause of progressive sensorineural hearing loss in this vulnerable population.
  • Informs clinical practice regarding the management of hearing complications in pediatric LCH patients.

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