CMV infection associated with severe lung involvement and persistent pulmonary hypertension of the newborn (PPHN) in two preterm twin neonates

Paolo Manzoni, Mauro Vivalda, Michael Mostert, Claudio Priolo, Paolo Galletto, Elena Gallo, Mauro Stronati, Renata Gili, Anna Opramolla, Sara Calabrese, Elena Tavella, Martina Luparia, Daniele Farina

Research output: Contribution to journalArticlepeer-review

Abstract

The diagnosis of congenital CMV is usually guided by a number of specific symptoms and findings. Unusual presentations may occur and diagnosis is challenging due to uncommon or rare features.Here we report the case of two preterm, extremely low birthweight, 28-week gestational age old twin neonates with CMV infection associated with severe lung involvement and persistent pulmonary hypertension of the newborn (PPHN). They were born to a HIV-positive mother, hence they underwent treatment with zidovudine since birth. Both infants featured severe refractory hypoxemia, requiring high-frequency ventilation, inhaled nitric oxide and inotropic support, with full recovery after 2 months. Treatment with ganciclovir was not feasible due the concomitant treatment with zidovudine and the risk of severe, fatal toxicity. Therefore administration of intravenous hyperimmune anti-CMV immunoglobulin therapy was initiated. Severe lung involvement at birth and subsequent pulmonary hypertension are rarely described in preterm infants as early manifestations of CMV congenital disease. In the two twin siblings here described, the extreme prematurity and the treatment with zidovudine likely worsened immunosuppression and ultimately required a complex management of the CMV-associated lung involvement.

Original languageEnglish
Pages (from-to)S25-S27
JournalEarly Human Development
Volume90
DOIs
Publication statusPublished - 2014

Keywords

  • CMV
  • Infection
  • Neonate
  • Preterm
  • Pulmonary hypertension

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynaecology
  • Medicine(all)

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