Postnatal Cytomegalovirus Infection in a Neonatal Intensive Care Unit: A Retrospective Study.

Area of Science:

• Neonatalogy
• Infectious Diseases
• Pediatric Critical Care

Background:

• Postnatal cytomegalovirus (pCMV) infection is a significant cause of morbidity in extremely preterm infants and those with very low birth weight.
• Neonatal intensive care units (NICUs) frequently encounter pCMV cases, necessitating a clear understanding of its impact.

Purpose of the Study:

• To describe the clinical features, management strategies, and outcomes of neonates diagnosed with pCMV infection in a level III NICU.
• To evaluate the effectiveness of antiviral therapy and identify common complications associated with pCMV in this vulnerable population.

Main Methods:

• A retrospective case series analyzed data from 12 neonates diagnosed with pCMV infection between 2013 and 2024.
• Congenital CMV infection was ruled out via early urine testing. Data on clinical presentation, laboratory findings, and follow-up were extracted from medical records.

Main Results:

• Infants had a median gestational age of 25 weeks and birth weight of 699.5 grams. All developed bronchopulmonary dysplasia, and 66.7% experienced intraventricular hemorrhage (IVH).
• Hematological issues like neutropenia (81.8%) and thrombocytopenia (58.3%) were common. Antiviral therapy was given to 75% of patients, with 88.9% achieving viral clearance. Overall mortality was 25%.

Conclusions:

• pCMV infection in extremely preterm infants leads to severe morbidity, frequent complications, and substantial mortality.
• While antiviral treatment is effective for viral clearance, long-term neurodevelopmental impairment is a significant concern.
• Further prospective studies are crucial to differentiate pCMV sequelae from those of extreme prematurity and optimize management.