Grand Rounds

Interstitial Pneumonia and Cytomegalovirus Infection in a 2 month old Child


Ira Shah, Drishti Tolani
Medical Sciences Department, Pediatric Oncall, Mumbai, India.

Address for Correspondence: Dr Ira Shah, 1/B Saguna, 271/B St Francis Road, Vile Parle (W), Mumbai 400056.


Clinical Problem:
A 2 month old girl presented with cough and breathlessness. She was ventilated and detected to have bilateral interstitial pneumonia along with hypoglycemia. Her liver function tests were also abnormal and she required multiple blood and plasma transfusions apart from IV antibiotics. Her cytomegalovirus IgM was positive (4.84 IU/ml). Echocardiography showed left ventricular hypertrophy with diastolic dysfunction. HIV ELISA was negative. CMV viral load was 790 copies/ml. She was started on oral valganciclovir (250mg/sqm 12 hourly for 3 weeks and then 125mg/sqm 12 hourly for another 3 weeks) and she responded to same. Hearing assessment showed mild hearing loss in left ear. Ultrasound of skull was normal. Her liver functions normalized at 8 months of age. Her hearing assessment at 1 year of age was normal. She is advised yearly hearing and eye assessment.

Does interstital pneumonia with CMV need treatment with anti-herpes agents?


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