Necrotizing Retinitis Secondary to Congenital Cytomegalovirus Infection Associated with Severe Combined Immunodeficiency

Abstract

A 20-day-old male infant who was born at 39 weeks of gestation was admitted to neonatal intensive care unit due to severe respiratory insufficiency. In retinal examination, peripheric retinal white-black color areas that correspond to necrotizing retinitis, moderate vitritis, macular and optic nerve head involvement, vascular leakage, and sheathing indicating perivasculitis were revealed. Despite the fact that CMV specific IgM was undetectable, CMV DNA with high viral load was found in his blood sample by means of real-time polymerase chain reaction assay. Serologic examination (IgM) for rubella, toxoplasma, herpes simplex type 2, and human immunodeficiency virus (anti-HIV) was negative. During the further evaluation for systemic immune dysfunction, decreased immunoglobulin and lymphocyte levels that confirm the diagnosis of severe combined immunodeficiency have been reached. Although given systemic intravenous ganciclovir and antibiotics treatment, the patient died at the 4th month of life due to respiratory insufficiency.

Oral Ulcers Induced by Cytomegalovirus Infection: Report on Two Cases

“…6,9,[10][11][12][13][14][15][16][17][18] The most common manifestation is retinitis, which is responsible for many cases of symptoms of CMV infection. In the mouth, this virus can cause oral hairy leukoplakia, especially in patients with compromised immune systems.…”

“…6,9 In addition, other clinical manifestations are associated with CMV infection, including pancytopenia, infectious mononucleosis syndrome, infection in the CNS, and retinitis. 6,9,[10][11][12][13][14][15][16][17][18] However, oral manifestations of CMV infection are considered rare. 19 Although oral lesions resulting from CMV infection have been documented in several immunosuppressive conditions, oral involvement CMV has increased since the beginning of the AIDS epidemic.…”

Inborn Errors of Immunity in the Premature Infant: Challenges in Recognition and Diagnosis

“…Several other viruses also have a predilection for both premature infants and children with IEI and can present with ocular disease (28). Enteroviral retinopathy and CMV retinitis have been observed in full-term infants with SCID (29,30). Preterm infants are routinely surveyed for retinopathy of prematurity (ROP) while in the NICU.…”

CD4+ cells as a potential biomarker for cytomegalovirus retinitis in children with acute lymphocytic leukemia

“…The decrease of CD4+ T cells has been related to CMVR in immune deficiency syndrome like AIDS. [3] However, little is known about the relation between the level of T cells with different markers and the onset of CMVR in ALL patients under chemotherapy. Therefore, this study was designed to investigate the diagnostic value of T cells with different markers for cytomegalovirus retinitis after chemotherapy in patients with ALL.…”