SHORT REPORT

Gastrointestinal manifestations of postnatal cytomegalovirus infection in infants admitted to a neonatal intensive care unit over a five year period

J L Y Cheong, F M Cowan and N Modi

Department of Paediatrics, Division of Paediatrics, Obstetrics and Gynaecology, Faculty of Medicine, Chelsea and Westminster Hospital, Imperial College, London, UK

Correspondence to:
Correspondence to:
Dr Modi
Department of Paediatrics, Division of Paediatrics, Obstetrics and Gynaecology, Faculty of Medicine, Imperial College, 369 Fulham Road, London SW10 9NH, UK; n.modi{at}imperial.ac.uk

Sixteen cases of postnatal cytomegalovirus (CMV) infection were identified in a neonatal intensive care unit population over a five year period. Eleven of these infants had gastrointestinal signs at the time of presentation. These ranged from minor and transient (abdominal distension and enteral feed intolerance) to severe and life threatening (protein losing enteropathy, diarrhoea, and hypernatraemic dehydration). An initial diagnosis of necrotising enterocolitis was common, but no infant showed intestinal or hepatic portal pneumatosis. The gestational age of the infants was 24–38 weeks. All had received fresh maternal breast milk. It is suggested that CMV enteritis is added to the spectrum of clinical manifestations of postnatal CMV infection. Signs suggestive of necrotising enterocolitis with atypical features should prompt investigations for CMV infection.

Abbreviations: CMV, cytomegalovirus; DEAFF, detection of early antigen fluorescent foci; NEC, necrotising enterocolitis; PCR, polymerase chain reaction

Keywords: cytomegalovirus; diarrhoea; necrotising enterocolitis; breast milk; premature infant

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