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Postnatal cytomegalovirus infection in an extremely premature infant transmitted via breast milk: A case report

Korean Journal of Pediatrics 2009;52(9):1053-1058.
Published online September 15, 2009.
Postnatal cytomegalovirus infection in an extremely premature infant transmitted via breast milk: A case report
Ji Hye Kim2, Eun-Jin Chung2, Hyun Kyung Park2, Soo Ji Moon2, Su-Mi Choi1, Sung Hee Oh2
1Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
2Department of Pediatrics, Hanyang University School of Medicine, Seoul, Korea
산모의 모유를 통하여 감염된 극소 저체중 출생아에서의 거대세포바이러스 감염
김지혜2, 정은진2, 박현경2, 문수지2, 최수미1, 오성희2
1가톨릭대학교 의과대학 내과학교실
2한양대학교 의과대학 소아과학교실
Correspondence: 
Sung Hee Oh, Email: sungheeo@hanyang.ac.kr
Abstract
Cytomegalovirus (CMV) is one of the most commonly encountered viral pathogens in newborn infants and is found in 0.3-2.4% of all live births. It has been demonstrated that 40-96% of seropositive mothers shed the virus via their breast milk. Breast milk containing CMV can cause almost one-third of CMV infections occurring in infants. A case of postnatal CMV infection in an extremely premature infant (gestational age 24+5 weeks, birth weight 750 g) transmitted via breast milk is presented. For neonatal intensive care unit (NICU) management of severe thrombocytopenia, anemia, and sepsis syndrome, the infant received repeated transfusions of platelets; intravenous (IV) immunoglobulins; and gamma- irradiated, filtrated packed red cells and was fed her mother's breast milk since the second week of life. CMV infection was diagnosed with positive CMV immunoglobulin M (IgM) and positive urine CMV culture at the second month of life. Considering the negative CMV IgM and urine CMV culture at birth, postnatally-acquired CMV infection was suspected and confirmed with completely identical nucleotide sequence alignments of the infantile blood isolate and the maternal breast milk isolate. To our knowledge, this is the first case of proven postnatal CMV infection transmitted via breast milk in an extremely premature infant in Korea.
Key Words: Cytomegalovirus, Glycoprotein B, Breast milk, Infant, Very low birth weight


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