Cytomegalovirus Infection Associated with Atypical Bronchopulmonary Dysplasia In A Preterm Neonate: A Case Report

@#Cytomegalovirus (CMV) is frequently isolated from neonates. Symptomatic infection is only apparent in 10% of affected babies with particular predilection for the reticuloendothelial and central nervous system. Isolated respiratory system involvement is rarely encountered. We report a case of a premature 32 weeks infant who required prolonged oxygen dependency and treated for bronchopulmonary dysplasia. The diagnosis of CMV pneumonitis was only discovered after detection of CMV DNA in the bronchoalveolar lavage. A high level of clinical awareness is crucial as a definite diagnosis and treatment will significantly alter the morbidity and the cost of therapy.

Clinical Characteristics of Bronchopulmonary Dysplasia by Type and Severity

PURPOSE: The increased survival of preterm infants in the neonatal intensive care unit recently has resulted in an increased frequency of bronchopulmonary dysplasia (BPD), especially with atypical forms. However, there have been few studies compairing classic and atypical BPD. The aim of this study was to investigate the differences between these two types of BPD. METHODS: Infants with a gestational age less than 32 weeks born at the Seoul National University Hospital and Bundang Seoul National University Hospital from May 2004 to April 2007 were included. The data were categorized in 2 groups, classic and atypical BPD. We determined the incidence of BPD, and compared perinatal factors and postnatal managements between two groups. RESULTS: Among 260 study subjects, 141 (54.2%) infants had BPD. Classic BPD infants were 64 and atypical BPD infants were 77. Comparison of differences between 2 groups, classic BPD infants were associated with respiratory distress syndrome, patent ductus arteriosus, intrauterine growth restriction, more high-frequency ventilator (HFV) use, low 1 and 5 minute Apgar scores. Atypical BPD infants were associated with antenatal steroid use, maternal premature rupture of membrane and chorioamnionitis (CAM). In multivariate analysis, more HFV use was associated with classic BPD. Antenatal steroid use, clinical CAM and histological CAM were associated with atypical BPD. CONCLUSION: The results of this study showed that antenatal factors (antenatal steroid use, clinical CAM, histological CAM) were associated with atypical BPD and postnatal factors (HFV used more) were associated with classic BPD. Further studies are needed for prevention and treatment of BPD.