Intractable diarrhoea caused by cytomegalovirus enterocolitis in an immunocompetent term neonate

Amit Kumar Gupta1, Arti Maria, Deepak Goyal

  • 1Department of Pediatrics, PGIMER & Dr RML Hospital, New Delhi 110001, India.

Insights

Cytomegalovirus (CMV) can cause severe diarrhea in newborns. This case highlights that even healthy term infants can develop CMV enterocolitis, requiring prompt ganciclovir treatment.

Area of Science:

  • Neonatal Medicine
  • Infectious Diseases
  • Gastroenterology

Background:

  • Symptomatic cytomegalovirus (CMV) infection typically affects preterm and immunocompromised infants.
  • Common manifestations include rash, pneumonia, hepatosplenomegaly, and encephalitis.

Observation:

  • A case of intractable diarrhea at two weeks of age in an immunocompetent, term neonate is presented.
  • This diarrhea was caused by postnatally acquired cytomegalovirus (CMV) enterocolitis.

Findings:

  • This is the first reported case of intractable diarrhea due to postnatally acquired CMV in an immunocompetent term neonate.
  • The infant experienced protracted diarrhea suggestive of enterocolitis.

Implications:

  • Cytomegalovirus (CMV) should be considered in the differential diagnosis of intractable diarrhea in neonates.
  • Intravenous ganciclovir is indicated and therapeutic for cytomegalovirus (CMV) enterocolitis in neonates.

Related Concept Videos

Cytomegalovirus Disease01:27

Cytomegalovirus Disease

Cytomegalovirus (CMV) disease is caused by human cytomegalovirus, a double-stranded DNA virus of the Herpesviridae family. While primary CMV infection is often asymptomatic in immunocompetent individuals, the virus can cause severe disease in neonates and immunocompromised patients. CMV is the most common cause of congenital viral infection in the United States, and a major pathogen in solid organ and hematopoietic stem cell transplant recipients.CMV is transmitted via bodily fluids, sexual...
Bacterial Gastroenteritis01:18

Bacterial Gastroenteritis

Bacterial gastroenteritis, characterized by diarrhea, abdominal cramps, and vomiting, is often caused by ingestion of contaminated food or water and is frequently associated with pathogenic Escherichia coli strains. These microbes exploit two principal mechanisms to inflict disease.Shiga toxin–producing E. coli, also referred to as STEC—notably O157:H7—release Shiga toxins that target ribosomes, blocking protein synthesis. The B subunit of the toxin binds the host glycolipid receptor...
Viral Meningitis01:18

Viral Meningitis

Viral meningitis is the most common form of meningitis and is often referred to as aseptic meningitis to indicate the absence of bacterial involvement. It is generally milder than bacterial meningitis, with symptoms including fever, headache, stiff neck, drowsiness, nausea, photophobia, and vomiting. Rarely, more severe manifestations or death may occur. Common causative agents include enteroviruses, particularly coxsackie A and B viruses and echoviruses, all members of the Enterovirus genus...
Immunodeficiency Diseases01:25

Immunodeficiency Diseases

Immunodeficiency disorders are conditions in which the immune system's ability to fight infectious disease and cancer is compromised or entirely absent. The immune system comprises a complex network of cells, tissues, and organs that work together to protect the body from potentially harmful invaders. When this system is deficient or not functioning properly, it leaves the body susceptible to infections, diseases, or other complications.
There are three main causes of immunodeficiency disorders...
Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents01:18

Drugs Affecting GI Tract Motility: Antimicrobials as Antidiarrheal Agents

Acute diarrhea, a common gastrointestinal disturbance, is characterized by the rapid evacuation of fluid stools, leading to an excessive weight in fluid. This condition typically arises from disorders affecting intestinal water and electrolyte transport. It can be triggered by an increased osmotic load within the intestine, excessive secretion of electrolytes and water, mucosal exudation of protein and fluid, or altered intestinal motility. The primary risks of acute diarrhea are dehydration...
Encephalitis l: Introduction01:19

Encephalitis l: Introduction

Encephalitis is inflammation of the brain parenchyma, most often due to infections or autoimmune processes. It presents with neuropsychiatric features such as fever, altered mental status, behavioral changes, cognitive dysfunction, seizures, focal deficits, and sometimes autonomic instability. In some cases, the meninges are also involved, resulting in meningoencephalitis.Infectious CausesInfectious encephalitis is most commonly viral but can also result from bacterial, fungal, or parasitic...