Clinical analysis of cytomegalovirus-sepsis-like syndrome in premature infants
Objective To investigate the clinical characteristics and prognosis of cytomegalovirus-sepsis-like syndrome(CMV-SLS)in premature infants,and to provide the evidence for early clinical identification and treatment.Methods Premature infants with CMV-SLS admitted to Children's Hospital Affiliated of Zhengzhou University from January 1,2019 to December 31,2022 were selected as the research subjects,and their clinical characteristics,treatment,and prognosis were retrospectively analyzed.Results A total of seven cases of CMV-SLS were included,with a gestational age of(26.8±1.2)weeks and a birth weight of(890±121)g.The age of disease onset was 55(45,60)days,and the age of diagnosis was 67(56,71)days.All the seven cases were exclusively breast feeding after birth,and cytomegalovirus(CMV)DNA was detected positive in their breast milk when diagnosed with CMV-SLS.The common clinical features were fever,abdominal distension,liver function damage,decreased neutrophil and platelet counts.Pneumonia,neonatal necrotizing enterocolitis,hearing loss,and chorioretinitis were common.After the diagnosis was confirmed,all the seven cases were given intravenous treatment of ganciclovir and followed by oral formulations,with a course of treatment ranging from five to seven weeks.Two cases were treated with intravitreal injection of ganciclovir for chorioretinitis.All the seven cases survived.During the follow-up with a corrected gestational age of 12 months,one case had delayed intellectual and motor development,two cases had delayed motor development,and the remaining cases had normal development.Conclusions CMV-SLS in premature infants mainly occurs in extremely low birth weight infants,with atypical clinical manifestations and may be misdiagnosed easily.If extremely low birth weight infants who receive CMV DNA positive breast feeding show sepsis-like symptoms,the possibility of CMV infection should be considered,and early diagnosis and treatment should be carried out to prevent adverse outcomes.
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