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Published on: July 6, 2013
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.
Abstract:
Symptomatic cytomegalovirus (CMV) infection mainly affects preterm and immunocompromised infants and usually manifest as rash, pneumonia, hepatospleenomegaly or encephalitis. To our knowledge intractable diarrhoea at two weeks of age caused by postnatally acquired CMV in immunocompetent term neonate is not reported. An unusual case of postnatally acquired CMV enterocolitis manifesting as protracted diarrhoea in an immunocompetent baby in neonatal period is reported. We conclude that CMV should be considered in the differential diagnosis of intractable diarrhoea in neonatal period and treatment with intravenous ganciclovir for CMV enterocolitis is not only indicated but is therapeutic.
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