Postnatal Cytomegalovirus Infection with Gastritis in a Preterm Newborn: A Case Report and Literature Review

Long-term Outcomes after Postnatal Cytomegalovirus Infection in Low Birthweight Preterm Infants

“…10 All case reports demonstrated CMV inclusion bodies in the GI tract. 10,11,36 Although 1 prospective study of 596 infants found that preterm infants with high maternal breast milk CMV loads in the first 14 days of life were 3.3 times more likely to have necrotizing enterocolitis (NEC) than those with lower levels, most studies found no association between pCMV and NEC. 13,18,21,22,24,26,29,31,33 One hypothesis to explain the GI complications of pCMV is that CMV may increase intestinal permeability allowing bacterial translocation and further exaggeration of the inflammatory response.…”

“…8 Studies suggest that pCMV-infected infants are at increased risk for NDI and the impact may not be fully realized until school age. However, many potential confounders affect long-term NDI, including but not limited to, degree of prematurity, additional comorbidities, nutritional status, socioeconomic status and early 35 Case series 1990 Single center Suzumura et al 38 Case report 1996 n/a Bradshaw et al 3 Case report 2003 n/a Gessler et al 11 Case report 2004 n/a Bergman et al 1 Case report 2006 n/a Takahashi et al 39 Case report 2007 n/a Fischer et al 9 Case report 2010 n/a Baerts et al 41 Case report 2010 n/a Torregrossa et al 36 Case report 2015 n/a Modrzejewska et al 20 Case report 2018 n/a Gaona-Álvarez et al 10 Case report 2019 n/a Chang 40 Retrospective case control (abstract only) 2011 Multicenter Goelz et al 12 Retrospective cohort 2013 Single center Turner et al 29 Retrospective cohort 2014 Single center Kelly et al 17 Retrospective cohort 2015 Multicenter Yoo et al 33 Retrospective cohort 2015 Single center Mukhopadhyay et al 21 Retrospective cohort 2016 Single center Weimer et al 31 Retrospective cohort 2019 Multicenter Yeager et al 32 Prospective cohort 1983 Single center Paryani et al 37 Prospective cohort 1985 Single center Sawyer et al 28 Prospective cohort 1987 Single center Jim et al 15 Prospective cohort 2004 Single center Vollmer et al 30 Prospective cohort 2004 Single center Meier et al 19 Prospective cohort 2005 Single center Neuberger et al 22 Prospective cohort 2006 Single center Buxmann et al 5 Prospective cohort 2009 Single center Capretti et al 6 Prospective cohort 2009 Single center Nijman et al 25 Prospective cohort 2012 Single center Nijman et al 23 Prospective cohort 2012 Single center Wakabayashi et al 14 Prospective cohort 2012 Single center Nijman et al…”

“…Although most commonly acquired via breast milk, pCMV can be acquired through blood product transfusion (albeit rare with the use of CMV seronegative or leukoreduced blood products), genital secretions during childbirth, and horizontal transmission. 1–33 Transmission of pCMV to term and preterm infants ranges from 10% to 60%. 19,30 Full-term infants with pCMV are generally asymptomatic; however, 14%–50% of very low birthweight infants (VLBW) infants can present with fever, pneumonitis, thrombocytopenia, lymphocytosis, encephalitis, hepatosplenomegaly, hepatitis and opportunistic infections.…”

“…19,30 Full-term infants with pCMV are generally asymptomatic; however, 14%–50% of very low birthweight infants (VLBW) infants can present with fever, pneumonitis, thrombocytopenia, lymphocytosis, encephalitis, hepatosplenomegaly, hepatitis and opportunistic infections. 3,7,10–13,15–17,21,24,25,27,28,31,34–37 An acute sepsis-like illness occurs in approximately 1.4% of infected VLBW infants. 17 pCMV can have multisystem involvement; however, studies are conflicting and do not provide a cohesive narrative of its long-term outcomes.…”

“…17 pCMV can have multisystem involvement; however, studies are conflicting and do not provide a cohesive narrative of its long-term outcomes. 1–36,38–41 To address this gap, we conducted a systematic review to synthesize current information on the long-term morbidity of pCMV for neonatologists and general pediatricians. Understanding the full clinical impact of pCMV and the gaps in this knowledge will help guide future clinical trials.…”