ABSTRACT
@#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.
ABSTRACT
Cytomegalovirus (CMV) infection commonly affects patients who are in an immunocompromised state, such as acquired immune deficiency syndrome (AIDS) and during organ transplantation. Although cytomegalovirus infection does not occur frequently, it is a major cause of morbidity and mortality in patients suffering with connective tissue diseases, including dermatomyositis. Cytomegalovirus pneumonitis and retinitis has been rarely reported in patients with dermatomyositis. We report here on an usual case involving the simultaneous occurrence of cytomegalovirus pneumonitis and retinitis in a 39-year-old female with dermatomyositis, and this woman had been treated with steroids and immunosuppressive agents for the previous 5 months.
Subject(s)
Adult , Female , Humans , Acquired Immunodeficiency Syndrome , Connective Tissue Diseases , Cytomegalovirus , Cytomegalovirus Infections , Cytomegalovirus Retinitis , Dermatomyositis , Immunosuppressive Agents , Organ Transplantation , Pneumonia , Retinitis , Steroids , Stress, Psychological , TransplantsABSTRACT
Ganciclovir is an antiviral agent that is effective for cytomegalovirus (CMV) infection in immunocompromised hosts. But the benefits of treatment for the congenital CMV diseases are still controversial. Cytomegalovirus pneumonitis is very rare. And so, a few cases of ganciclovir therapy in CMV pneumonitis were reported. We experienced a case of a 7 month-old male infant with prolonged pneumonitis and respiratory difficulty which were not improved with steroid and antibiotic therapy for 2 months. He was born at gestational age of 32 weeks and received oxygen therapy with mask for 2 days only. On physical examination, tachypnea, chest retracion, inspiratory wheezing and rales were present. PaCO2 was 84.0 mmHg on blood gas analysis and the anti-CMV-IgM, -IgG antibodies were positive. But anti-CMV-IgM, -IgG antibodies of his mother were negative. The open lung biopsy revealed CMV inclusion in alveolar interstitium. CMV shell vial assay of patient's urine and tracheal aspirate were positive. Ganciclovir (5-10 mg/kg, 10weeks) had been given without any significant complications. After treatment of ganciclovir for 4 weeks, shell vial assay of tracheal aspirate for CMV showed negative conversion and anti-CMV-IgM antibody was converted negatively. CMV pneumonitis of this patient had the possibility of secondary infection associated with immunosuppressive status after long-term steroid therapy or with blood transfusion. We report a first case of ganciclovir therapy of CMV pneumonitis with review of related literatures.