Congenital Cytomegalovirus Pneumonitis and Treatment Response Evaluation Using Viral Load during Ganciclovir Therapy: a Case Report

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  • Lee-Yoshimoto Minsoo
    Department of Pediatrics, National Center for Global Health and Medicine
  • Goishi Keiji
    Department of Pediatrics, National Center for Global Health and Medicine
  • Torii Yuka
    Department of Pediatrics, Nagoya University Graduate School of Medicine
  • Ito Yoshinori
    Department of Pediatrics, Nagoya University Graduate School of Medicine
  • Ono Hiroya
    Department of Pediatrics, National Center for Global Health and Medicine
  • Mori Tomoko
    Department of Pediatrics, National Center for Global Health and Medicine
  • Kashiwa Naoyuki
    Department of Pediatrics, National Center for Global Health and Medicine
  • Hosokawa Shinichi
    Department of Pediatrics, National Center for Global Health and Medicine
  • Shichino Hiroyuki
    Department of Pediatrics, National Center for Global Health and Medicine

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<p>Cytomegalovirus (CMV) is the most common cause of congenital infection. Pneumonitis is considered to be a rare manifestation although congenital CMV infection presents with various non-specific findings. Ganciclovir and valganciclovir are beneficial for improving neurodevelopmental sequelae and hearing outcomes of congenital CMV infection; however, treatment response evaluation is not well reported. We report a female case of congenital CMV infection presenting with pneumonitis, meningoencephalitis, and chorioretinitis. She was treated with intravenous ganciclovir for 6 weeks, and clinical features improved. Measurement of the CMV genome load by real-time polymerase chain reaction assay was performed during treatment. After the administration of ganciclovir, the CMV genome was not detected in the blood and levels decreased gradually in the urine. Physicians should consider the possibility of congenital CMV infection in neonates who present with respiratory distress. Furthermore, measurement of the CMV genome load in blood and urine may be useful for evaluating treatment response.</p>

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