Recommendations for Diagnosis and Prevention of Cytomegalovirus-Associated Necrotizing Enterocolitis in Breast-Fed...

Area of Science:

• Neonatal Medicine
• Pediatric Infectious Diseases
• Gastroenterology

Background:

• Postnatally acquired cytomegalovirus (CMV) can cause severe complications in preterm infants.
• Necrotizing enterocolitis (NEC) is a serious gastrointestinal emergency in neonates.
• CMV infection is an underrecognized cause of NEC and other GI issues in infants.

Purpose of the Study:

• To report a case of severe necrotizing enterocolitis and thrombocytopenia in a preterm infant due to cytomegalovirus.
• To review the literature on cytomegalovirus-related gastrointestinal complications in infants.
• To highlight the efficacy of ganciclovir in treating CMV-associated NEC.

Main Methods:

• Case presentation of a preterm infant with CMV infection, NEC, and thrombocytopenia.
• Administration of intravenous ganciclovir upon CMV diagnosis.
• Comprehensive literature review of CMV-related gastrointestinal disease in neonates and infants.

Main Results:

• The infant experienced severe thrombocytopenia and clinical deterioration unresponsive to transfusions.
• Intravenous ganciclovir treatment resulted in significant clinical improvement.
• Literature review identified other cases of CMV-associated NEC and GI complications.

Conclusions:

• Cytomegalovirus should be considered in the differential diagnosis of severe NEC and thrombocytopenia in preterm infants.
• Ganciclovir is an effective treatment for cytomegalovirus-related gastrointestinal disease in infants.
• Early diagnosis and treatment of CMV are crucial for improving outcomes in affected neonates.