FULMINANT CMV INFECTION IN NEONATE
Dr. Atul Kulkarni*, Dr. Vijaykumar Gutte (Registrar)**
Dept of Paediatrics, Ashwini Sahakari Rugnalaya & Research Centre, Solapur.*, Dept of Paediatrics, Ashwini Sahakari Rugnalaya & Research Centre, Solapur.**
Case History: Antenatal - Primigravida
No other positive history

Birth History: Full term normal vaginal delivery. Baby cried immediately after birth. Male, 3.8 kg.

On day 1, patient was having purpuric rash all over the body and hepatosplenomegaly. On investigation patient was having Hb level 13 gm%, gradually develops anemia (Hb-7.5 gm%), thrombocytopenia, increased SGPT and plate count 7000/cm3 hyperbilirubinemia (Serum bilirubin 12). Jaundice gradually increased up to bilirubin levels 36 mg/dl with direct bilirubin 25 mg/dl. USG showed mild hepatosplenomegaly, CSF showed xanthochromia. VDRL & G6-PD was negative. CT scan shows mild cerebral oedema. CMV PCR positive. Patient developed altered sensorium, had convulsions and expired.

CMV: It is the most common cause of congenital infection. In neonate, there is wide spectrum of manifestation of diseases like:
  • Asymptomatic
  • Acute Fulminant form
  • Chronic form

Acute infection involves multiple organ system with petechiae, purpura, hepatosplenomegaly, jaundice, anemia and thrombocytopenia.

In chronic form, babies have microcephaly, intrauterine growth retardation. Calcification may occur anywhere in the brain but classically found in periventricular area.
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