Clinical experience with ganciclovir and anti-cytomegalovirus immunoglobulin treatment for a severe case of congenital cytomegalovirus infection

Abstract

We report on a female neonate with severe onset of congenital cytomegalovirus (CMV) infection. She was noted to have cerebral ventriculomegaly on antenatal ultrasound, and presented with petechia after birth. Laboratory tests revealed severe thrombocytopenia (platelet count, 11,000/mm3) and hypoglycemia (serum glucose level, 5 mg/dl). Hepatosplenomegaly with elevated hepatic enzymes, retinitis, conjugated hyperbilirubinemia, and diffuse brainstem anomaly were also found in subsequent examinations. The diagnosis was confirmed by positive CMV-IgM from serum and the isolation of CMV from a urine sample. The patient received intravenous ganciclovir and human anti-CMV immunoglobulin during admission. She was discharged at the age of 61 days and followed-up monthly at our clinics. Symptoms and signs subsided except for mild cerebral ventriculomegaly at her last visit. We demonstrate a successful treatment with the combined use of ganciclovir and anti-CMV immunoglobulin.