Cytomegalovirus infection of the bowel in infancy: pathogenetic and diagnostic significance

Area of Science:

• Gastroenterology
• Virology
• Pediatric Pathology

Background:

• Cytomegalovirus (CMV) is a common virus that can cause significant illness in infants.
• Gastrointestinal manifestations of CMV infection in neonates are varied and can mimic other congenital disorders.
• Accurate diagnosis of bowel pathologies in infants is critical for timely intervention and management.

Observation:

• This study examined three infants with confirmed cytomegalovirus (CMV) infection affecting the bowel.
• In two infants, CMV infection was identified within the enteric ganglion cells.
• The third infant presented with classic short segment Hirschsprung's disease and colitis, showing CMV inclusions in vascular endothelium.

Findings:

• CMV infection of enteric ganglion cells was observed in two infants, with one exhibiting hypoganglionosis and colonic dysmotility.
• The third infant's condition, characterized by Hirschsprung's disease and colitis, showed CMV in vascular endothelium.
• The presence of viral transformed cells in the third case raises concerns about potential diagnostic biopsy misinterpretation.

Implications:

• CMV infection should be considered in the differential diagnosis of neonatal bowel disorders, including Hirschsprung's disease and dysmotility.
• Histopathological interpretation of infant bowel biopsies requires awareness of potential CMV involvement, especially in cases of colitis or vascular endothelial changes.
• Understanding the role of CMV in enteric neuropathies can improve diagnostic accuracy and guide therapeutic strategies for affected infants.