Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia

Nipun Shrestha; Bhabuk Sharma Majagaiya; Dhruba Shrestha

doi:doi:10.11648/j.ajp.20190504.21

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Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia

Nipun Shrestha, Bhabuk Sharma Majagaiya, Dhruba Shrestha

Published in American Journal of Pediatrics (Volume 5, Issue 4)

Received: 12 August 2019 Accepted: 6 September 2019 Published: 23 October 2019

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Abstract

Human Cytomegalovirus (CMV) is a member of Herpes viridae family, that affects most of the human population at some stage of live and is the most common congenital infection causing sensorineural hearing loss and neurodevelopmental delay in newborn. CMV infection may be acquired in a newborn congenitally or after delivery, but except for the congenital infection, other mode of infection rarely result in significant symptoms or sequel in them. Clinical findings of congenital CMV infection include IUGR, hydrops, generalized petechiae, purpura, thrombocytopenia, jaundice, hepatosplenomegaly, pneumonitis, microcephaly, periventricular calcifications, seizures, chorioretinitis, sensorineural hearing loss, bone abnormalities, abnormal dentition, and hypocalcified enamel. Here we present a case of congenital CMV infection who presented with Pneumonia with Respiratory distress and thrombocytopenia. A single, live, term, female child delivered at home developed low grade fever, cough and increased oral secretion at 28 day of life and was initially diagnosed as Pneumonia with respiratory distress with thrombocytopenia. Mother and child, both were investigated for TORCH infection which came out to be positive for CMV infection (child’s serum CMV Ab IgM 94 U/ml). Her CMV Viral Load Real Time PCR tested positive with 56380 copies/ml.

Published in	American Journal of Pediatrics (Volume 5, Issue 4)
DOI	10.11648/j.ajp.20190504.21
Page(s)	230-233
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Human Cytomegalovirus, Herpes Viridae, Thrombocytopenia, TORCH

References

[1]	Van Zuylen WJ, Hamilton ST, Naing Z, Hall B, Shand A, Rawlinson WD. Congenital cytomegalovirus infection: Clinical presentation, epidemiology, diagnosis and prevention. Obstetric medicine. 2014 Dec; 7 (4): 140-6.
[2]	Swanson EC, Schleiss MR. Congenital cytomegalovirus infection: new prospects for prevention and therapy. Pediatric Clinics. 2013 Apr 1; 60 (2): 335-49.
[3]	Schleiss MR. Acquisition of human cytomegalovirus infection in infants via breast milk: natural immunization or cause for concern? Reviews in medical virology. 2006 Mar; 16 (2): 73-82.
[4]	Manicklal S, Emery VC, Lazzarotto T, et al. The ‘‘silent’’ global burden of congenital cytomegalovirus. Clin Microbiol Rev 2013; 26: 86–102.
[5]	Cannon MJ, Schmid DS and Hyde TB. Review of cytomegalovirus seroprevalence and demographic characteristics associated with infection. Rev Med Virol 2010; 20: 202–213.
[6]	Pass RF, Fowler KB, Boppana SB, et al. Congenital cytomegalovirus infection following first trimester maternal infection: symptoms at birth and outcome. J Clin Virol 2006; 35: 216–220.
[7]	Dollard SC, Grosse SD, Ross DS. New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection. Rev Med Virol. 2007; 17 (5): 355–363. [PubMed: 17542052].
[8]	Boppana SB, Pass RF, Britt WJ, et al. Symptomatic congenital cytomegalovirus infection: neonatal morbidity and mortality. Pediatr Infect Dis J. 1992; 11 (2): 93–99.
[9]	Conboy TJ, Pass RF, Stagno S, et al. Early clinical manifestations and intellectual outcome in children with symptomatic congenital cytomegalovirus infection. J Pediatr. 1987; 111 (3): 343–348.
[10]	Pass RF, Stagno S, Myers GJ, et al. Outcome of symptomatic congenital cytomegalovirus infection: results of long-term longitudinal follow-up. Pediatrics. 1980; 66 (5): 758–762.
[11]	Bhatia P, Narang A, Minz RW. Neonatal cytomegalovirus infection: diagnostic modalities available for early disease detection. Indian J Pediatr. 2010; 77 (1): 77–79.
[12]	Boppana SB, Ross SA, Shimamura M, et al. Saliva polymerase-chain-reaction assay for cytomegalovirus screening in newborns. N Engl J Med. 2011; 364 (22): 2111–2118.
[13]	Yamamoto AY, Mussi-Pinhata MM, Marin LJ, et al. Is saliva as reliable as urine for detection of cytomegalovirus DNA for neonatal screening of congenital CMV infection? Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology. 2006; 36 (3): 228–230.

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Nipun Shrestha, Bhabuk Sharma Majagaiya, Dhruba Shrestha. (2019). Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia. American Journal of Pediatrics, 5(4), 230-233. https://doi.org/10.11648/j.ajp.20190504.21

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ACS Style

Nipun Shrestha; Bhabuk Sharma Majagaiya; Dhruba Shrestha. Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia. Am. J. Pediatr. 2019, 5(4), 230-233. doi: 10.11648/j.ajp.20190504.21

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AMA Style

Nipun Shrestha, Bhabuk Sharma Majagaiya, Dhruba Shrestha. Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia. Am J Pediatr. 2019;5(4):230-233. doi: 10.11648/j.ajp.20190504.21

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@article{10.11648/j.ajp.20190504.21,
  author = {Nipun Shrestha and Bhabuk Sharma Majagaiya and Dhruba Shrestha},
  title = {Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia},
  journal = {American Journal of Pediatrics},
  volume = {5},
  number = {4},
  pages = {230-233},
  doi = {10.11648/j.ajp.20190504.21},
  url = {https://doi.org/10.11648/j.ajp.20190504.21},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20190504.21},
  abstract = {Human Cytomegalovirus (CMV) is a member of Herpes viridae family, that affects most of the human population at some stage of live and is the most common congenital infection causing sensorineural hearing loss and neurodevelopmental delay in newborn. CMV infection may be acquired in a newborn congenitally or after delivery, but except for the congenital infection, other mode of infection rarely result in significant symptoms or sequel in them. Clinical findings of congenital CMV infection include IUGR, hydrops, generalized petechiae, purpura, thrombocytopenia, jaundice, hepatosplenomegaly, pneumonitis, microcephaly, periventricular calcifications, seizures, chorioretinitis, sensorineural hearing loss, bone abnormalities, abnormal dentition, and hypocalcified enamel. Here we present a case of congenital CMV infection who presented with Pneumonia with Respiratory distress and thrombocytopenia. A single, live, term, female child delivered at home developed low grade fever, cough and increased oral secretion at 28 day of life and was initially diagnosed as Pneumonia with respiratory distress with thrombocytopenia. Mother and child, both were investigated for TORCH infection which came out to be positive for CMV infection (child’s serum CMV Ab IgM 94 U/ml). Her CMV Viral Load Real Time PCR tested positive with 56380 copies/ml.},
 year = {2019}
}

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TY  - JOUR
T1  - Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia
AU  - Nipun Shrestha
AU  - Bhabuk Sharma Majagaiya
AU  - Dhruba Shrestha
Y1  - 2019/10/23
PY  - 2019
N1  - https://doi.org/10.11648/j.ajp.20190504.21
DO  - 10.11648/j.ajp.20190504.21
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 230
EP  - 233
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20190504.21
AB  - Human Cytomegalovirus (CMV) is a member of Herpes viridae family, that affects most of the human population at some stage of live and is the most common congenital infection causing sensorineural hearing loss and neurodevelopmental delay in newborn. CMV infection may be acquired in a newborn congenitally or after delivery, but except for the congenital infection, other mode of infection rarely result in significant symptoms or sequel in them. Clinical findings of congenital CMV infection include IUGR, hydrops, generalized petechiae, purpura, thrombocytopenia, jaundice, hepatosplenomegaly, pneumonitis, microcephaly, periventricular calcifications, seizures, chorioretinitis, sensorineural hearing loss, bone abnormalities, abnormal dentition, and hypocalcified enamel. Here we present a case of congenital CMV infection who presented with Pneumonia with Respiratory distress and thrombocytopenia. A single, live, term, female child delivered at home developed low grade fever, cough and increased oral secretion at 28 day of life and was initially diagnosed as Pneumonia with respiratory distress with thrombocytopenia. Mother and child, both were investigated for TORCH infection which came out to be positive for CMV infection (child’s serum CMV Ab IgM 94 U/ml). Her CMV Viral Load Real Time PCR tested positive with 56380 copies/ml.
VL  - 5
IS  - 4
ER  -

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Author Information

Nipun Shrestha

Siddhi Memorial Hospital (for Women and Children), Bhaktapur, Nepal
Bhabuk Sharma Majagaiya

Siddhi Memorial Hospital (for Women and Children), Bhaktapur, Nepal
Dhruba Shrestha

Siddhi Memorial Hospital (for Women and Children), Bhaktapur, Nepal

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Plain Text BibTeX RIS

APA Style

Nipun Shrestha, Bhabuk Sharma Majagaiya, Dhruba Shrestha. (2019). Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia. American Journal of Pediatrics, 5(4), 230-233. https://doi.org/10.11648/j.ajp.20190504.21

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ACS Style

Nipun Shrestha; Bhabuk Sharma Majagaiya; Dhruba Shrestha. Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia. Am. J. Pediatr. 2019, 5(4), 230-233. doi: 10.11648/j.ajp.20190504.21

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AMA Style

Nipun Shrestha, Bhabuk Sharma Majagaiya, Dhruba Shrestha. Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia. Am J Pediatr. 2019;5(4):230-233. doi: 10.11648/j.ajp.20190504.21

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@article{10.11648/j.ajp.20190504.21,
  author = {Nipun Shrestha and Bhabuk Sharma Majagaiya and Dhruba Shrestha},
  title = {Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia},
  journal = {American Journal of Pediatrics},
  volume = {5},
  number = {4},
  pages = {230-233},
  doi = {10.11648/j.ajp.20190504.21},
  url = {https://doi.org/10.11648/j.ajp.20190504.21},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20190504.21},
  abstract = {Human Cytomegalovirus (CMV) is a member of Herpes viridae family, that affects most of the human population at some stage of live and is the most common congenital infection causing sensorineural hearing loss and neurodevelopmental delay in newborn. CMV infection may be acquired in a newborn congenitally or after delivery, but except for the congenital infection, other mode of infection rarely result in significant symptoms or sequel in them. Clinical findings of congenital CMV infection include IUGR, hydrops, generalized petechiae, purpura, thrombocytopenia, jaundice, hepatosplenomegaly, pneumonitis, microcephaly, periventricular calcifications, seizures, chorioretinitis, sensorineural hearing loss, bone abnormalities, abnormal dentition, and hypocalcified enamel. Here we present a case of congenital CMV infection who presented with Pneumonia with Respiratory distress and thrombocytopenia. A single, live, term, female child delivered at home developed low grade fever, cough and increased oral secretion at 28 day of life and was initially diagnosed as Pneumonia with respiratory distress with thrombocytopenia. Mother and child, both were investigated for TORCH infection which came out to be positive for CMV infection (child’s serum CMV Ab IgM 94 U/ml). Her CMV Viral Load Real Time PCR tested positive with 56380 copies/ml.},
 year = {2019}
}

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TY  - JOUR
T1  - Congenital Cytomegalovirus Infection Presenting as Pneumonia with Respiratory Distress and Thrombocytopenia
AU  - Nipun Shrestha
AU  - Bhabuk Sharma Majagaiya
AU  - Dhruba Shrestha
Y1  - 2019/10/23
PY  - 2019
N1  - https://doi.org/10.11648/j.ajp.20190504.21
DO  - 10.11648/j.ajp.20190504.21
T2  - American Journal of Pediatrics
JF  - American Journal of Pediatrics
JO  - American Journal of Pediatrics
SP  - 230
EP  - 233
PB  - Science Publishing Group
SN  - 2472-0909
UR  - https://doi.org/10.11648/j.ajp.20190504.21
AB  - Human Cytomegalovirus (CMV) is a member of Herpes viridae family, that affects most of the human population at some stage of live and is the most common congenital infection causing sensorineural hearing loss and neurodevelopmental delay in newborn. CMV infection may be acquired in a newborn congenitally or after delivery, but except for the congenital infection, other mode of infection rarely result in significant symptoms or sequel in them. Clinical findings of congenital CMV infection include IUGR, hydrops, generalized petechiae, purpura, thrombocytopenia, jaundice, hepatosplenomegaly, pneumonitis, microcephaly, periventricular calcifications, seizures, chorioretinitis, sensorineural hearing loss, bone abnormalities, abnormal dentition, and hypocalcified enamel. Here we present a case of congenital CMV infection who presented with Pneumonia with Respiratory distress and thrombocytopenia. A single, live, term, female child delivered at home developed low grade fever, cough and increased oral secretion at 28 day of life and was initially diagnosed as Pneumonia with respiratory distress with thrombocytopenia. Mother and child, both were investigated for TORCH infection which came out to be positive for CMV infection (child’s serum CMV Ab IgM 94 U/ml). Her CMV Viral Load Real Time PCR tested positive with 56380 copies/ml.
VL  - 5
IS  - 4
ER  -

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