All issues > Volume 52(9); 2009

Case Report

Korean J Pediatr. 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 JH Kim², Eun-Jin EJ Chung², Hyun Kyung HK Park², Soo Ji SJ Moon², Su-Mi SM Choi¹, Sung Hee SH Oh²

¹Department of Internal Medicine, The Catholic University of Korea, Seoul, Korea
²Department of Pediatrics, Hanyang University School of Medicine, Seoul, Korea

Correspondence Sung Hee SH 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.

Keywords :Cytomegalovirus, Glycoprotein B, Breast milk, Infant, Very low birth weight