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A Case of an Extremely Preterm Infant with Intussusception Triggered by Acquired Cytomegalovirus Infection

Sanae Naito1, Sachiyo Fukushima2, Tomoaki Ioroi2

  • 1Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan.

The Kobe Journal of Medical Sciences
|June 27, 2024
PubMed

Insights

Intussusception is rare in preterm neonates, often mimicking necrotizing enterocolitis. A case revealed acquired cytomegalovirus enteritis as a cause, highlighting the need for early diagnosis in neonates.

Area of Science:

  • Neonatal Medicine
  • Pediatric Surgery
  • Infectious Diseases

Background:

  • Intussusception is a common cause of intestinal obstruction in infants but rare in preterm neonates (IPN).
  • Etiology of IPN is unclear; prenatal injuries are suspected.
  • Diagnosis is challenging due to symptom overlap with necrotizing enterocolitis (NEC).

Observation:

  • A very preterm infant presented with intussusception.
  • Symptoms mimicked NEC, delaying diagnosis.
  • Ultrasonography aided diagnosis.

Findings:

  • The intussusception was linked to acquired cytomegalovirus (aCMV) infection.
  • CMV enteritis caused intestinal edema and dysmotility, leading to intussusception.
  • CMV-DNA-PCR confirmed the viral presence in resected tissue.

Implications:

  • Acquired cytomegalovirus enteritis is a potential cause of neonatal intussusception.
  • Early diagnosis is critical due to differing treatments for IPN and NEC.
  • This case underscores the importance of considering infectious etiologies in neonatal intestinal obstruction.

Keywords:
Acquired cytomegalovirus (aCMV) infectionIntussusception in preterm neonates (IPN)Necrotizing enterocolitis (NEC)

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