Abstract

Gastrointestinal manifestations of congenital cytomegalovirus (CMV) infection in premature infants vary from diarrhea to necrotizing enterocolitis. A 35-week-old premature girl was born with intrauterine growth retardation and went thru

phototherapy owing to hyperbilirubinemia. She had thrombocytopenia resolved with intravenous immunoglobulin at the day 3 of life. In the laboratory investigation for ethiopathogenesis of organomegaly and thrombocytopenia, firstly anti-CMV-IgM and later blood CMV-PCR were found to be positive at the 5th day of life. Meanwhile, she failed to thrive and was occasionally having abdominal distention and vomiting. On the 32nd day of admission, vomiting attacks increased and she developed diarrhea. Abdominal X-ray showed dilatation and intramural air on the bowel walls. These findings on the whole suggested necrotizing enterocolitis, as a complication of congenital CMV infection, leading the patient’s death in a short term. This patient teaches us that rare but severe gastrointestinal complications such as necrotizing enterocolitis in a premature neonate might be mediated by congenital CMV infection.