Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Perinatal/Neonatal Case Presentation
  • Published:

Perinatal/Neonatal Case Presentation

Nonimmune Hydrops Fetalis and Fulminant Fatal Disease Due to Congenital Cytomegalovirus Infection in a Premature Infant

Journal of Perinatology volume 25, pages 608–611 (2005)Cite this article

Abstract

We report a case of fatal congenital cytomegalovirus (CMV) disease in a 695 gm, 29 weeks estimated gestational age premature infant. The newborn presented with hydrops fetalis, an unusual presentation of congenital CMV infection. In spite of ganciclovir therapy, the infant succumbed to his illness. Autopsy findings revealed the presence of widespread CMV disease, including pneumonitis, enteritis, and myocarditis. Congenital CMV infection should be considered in the differential diagnosis of hydrops fetalis.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1
Figure 2
Figure 3

Similar content being viewed by others

References

  1. Lallemand AV, Doco-Fenzy M, Gaillard DA . Investigation of nonimmune hydrops fetalis: multidisciplinary studies are necessary for diagnosis — review of 94 cases. Pediatr Dev Pathol 1999;2(5):432–439.

    Article  CAS  Google Scholar 

  2. Barron SD, Pass RF . Infectious causes of hydrops fetalis. Semin Perinatol 1995;19(6):493–501.

    Article  CAS  Google Scholar 

  3. Enders M, Weidner A, Zoellner I, Searle K, Enders G . Fetal morbidity and mortality after acute human parvovirus B19 infection in pregnancy: prospective evaluation of 1018 cases. Prenat Diagn 2004;24(7):513–518.

    Article  Google Scholar 

  4. Schleiss MR, McVoy MA . Overview of congenitally and perinatally acquired cytomegalovirus infections: recent advances in antiviral therapy. Expert Rev Anti Infect Ther 2004;2(3):389–403.

    Article  CAS  Google Scholar 

  5. O'Malley A, Barry-Kinsella C, Hughes C, et al. Parvovirus infects cardiac myocytes in hydrops fetalis. Pediatr Dev Pathol 2003;6(5):414–420.

    Article  Google Scholar 

  6. Dehtiar N, Eherlichman M, Picard E, et al. Cytomegalovirus myocarditis in a healthy infant: complete recovery after ganciclovir treatment. Pediatr Crit Care Med 2001;2(3):271–273.

    Article  Google Scholar 

  7. Bissinger AL, Sinzger C, Kaiserling E, Jahn G . Human cytomegalovirus as a direct pathogen: correlation of multiorgan involvement and cell distribution with clinical and pathological findings in a case of congenital inclusion disease. J Med Virol 2002;67(2):200–206.

    Article  CAS  Google Scholar 

  8. Beksac MS, Saygan-Karamursel B, Ustacelebi S, et al. Prenatal diagnosis of intrauterine cytomegalovirus infection in a fetus with non-immune hydrops fetalis. Acta Obstet Gynecol Scand 2001;80(8):762–765.

    Article  CAS  Google Scholar 

  9. Mazeron MC, Cordovi-Voulgaropoulos L, Perol Y . Transient hydrops fetalis associated with intrauterine cytomegalovirus infection: prenatal diagnosis. Obstet Gynecol 1994;84(4, Part 2):692–694.

    CAS  PubMed  Google Scholar 

  10. Inoue T, Matsumura N, Fukuoka M, Sagawa N, Fujii S . Severe congenital cytomegalovirus infection with fetal hydrops in a cytomegalovirus-seropositive healthy woman. Eur J Obstet Gynecol Reprod Biol 2001;95(2):184–186.

    Article  CAS  Google Scholar 

  11. Boppana SB, Rivera LB, Fowler KB, Mach M, Britt WJ . Intrauterine transmission of cytomegalovirus to infants of women with preconceptional immunity. N Engl J Med 2001;344(18):1366–1371.

    Article  CAS  Google Scholar 

  12. Ahlfors K, Ivarsson SA, Harris S . Report on a long-term study of maternal and congenital cytomegalovirus infection in Sweden. Review of prospective studies available in the literature. Scand J Infect Dis 1999;31(5):443–457.

    Article  CAS  Google Scholar 

  13. Revello MG, Gerna G . Diagnosis and management of human cytomegalovirus infection in the mother, fetus, and newborn infant. Clin Microbiol Rev 2002;15:680–715.

    Article  Google Scholar 

  14. Schleiss MR, Bernstein DI, McVoy MA, et al. The non-nucleoside antiviral, BAY 38-4766, protects against cytomegalovirus (CMV) disease and mortality in immunocompromised guinea pigs. Antiviral Res 2005;65(1):35–43.

    Article  CAS  Google Scholar 

  15. Kimberlin DW, Lin CY, Sanchez PJ, et al. National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. Effect of ganciclovir therapy on hearing in symptomatic congenital cytomegalovirus disease involving the central nervous system: a randomized, controlled trial. J Pediatr 2003;143(1):16–25.

    Article  CAS  Google Scholar 

  16. Hocker J, Cook LN, Adams G, Rabalais G . Ganciclovir therapy of congenital cytomegalovirus pneumonia. Pediatr Infect Dis J 1990;9:743–745.

    Article  CAS  Google Scholar 

  17. Attard-Montalto SP, English MC, Stimmler L, Snodgrass GJ . Ganciclovir treatment of congenital cytomegalovirus infection: a report of two cases. Scand J Infect Dis 1993;25(3):385–388.

    Article  CAS  Google Scholar 

  18. Stronati M, Revello MG, Cerbo RM, Furione M, Rondini G, Gerna G . Ganciclovir therapy of congenital human cytomegalovirus hepatitis. Acta Paediatr 1995;84(3):340–341.

    Article  CAS  Google Scholar 

  19. Vallejo JG, Englund JA, Garcia-Prats JA, Demmler GJ . Ganciclovir treatment of steroid-associated cytomegalovirus disease in a congenitally infected neonate. Pediatr Infect Dis J 1994;13(3):239–241.

    Article  CAS  Google Scholar 

  20. Michaels MG, Greenberg DP, Sabo DL, Wald ER . Treatment of children with congenital cytomegalovirus infection with ganciclovir. Pediatr Infect Dis J 2003;22(6):504–509.

    PubMed  Google Scholar 

  21. Nigro G, Scholz H, Bartmann U . Ganciclovir therapy for symptomatic congenital cytomegalovirus infection in infants: a two-regimen experience. J Pediatr 1994;124(2):318–322.

    Article  CAS  Google Scholar 

  22. Crowley B . Ganciclovir treatment of symptomatic congenital cytomegalovirus infection. J Antimicrob Chemother 2002;50(3):435–436.

    Article  CAS  Google Scholar 

  23. Fischler B, Casswall TH, Malmborg P, Nemeth A . Ganciclovir treatment in infants with cytomegalovirus infection and cholestasis. J Pediatr Gastroenterol Nutr 2002;34(2):154–157.

    Article  CAS  Google Scholar 

  24. Griffiths PD, Walter S . Cytomegalovirus. Curr Opin Infect Dis 2005;18(3):241–245.

    Article  Google Scholar 

  25. Plotkin SA . Vaccination against cytomegalovirus, the changeling demon. Pediatr Infect Dis J 1999;18:313–325.

    Article  CAS  Google Scholar 

  26. Schleiss MR, Heineman TC . Progress toward an elusive goal: current status of cytomegalovirus (CMV) vaccines. Expert Rev Vaccines 2005;4(3):381–406.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

Helpful discussions with Tenessa MacKenzie, University of Florida School of Medicine, are acknowledged. Grant support is acknowledged for study of congenital CMV infection (NIH HD38416-01, HD44864-01, and the March of Dimes Birth Defects Foundations FY01-22).

Author information

Authors and Affiliations

  1. Department of Pediatrics, Division of Neonatology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA

    Venkatesh Sampath MD, Vivek Narendran MD & Edward F Donovan MD

  2. Department of Pathology, University of Cincinnati School of Medicine, Cincinnati, OH, USA

    Jerzy Stanek PhD

  3. Department of Pediatrics, Division of Pediatric Infectious Diseases, University of Minnesota School of Medicine, Minneapolis, MN, USA

    Mark R Schleiss MD

Authors
  1. Venkatesh Sampath MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vivek Narendran MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Edward F Donovan MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Jerzy Stanek PhD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Mark R Schleiss MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Sampath, V., Narendran, V., Donovan, E. et al. Nonimmune Hydrops Fetalis and Fulminant Fatal Disease Due to Congenital Cytomegalovirus Infection in a Premature Infant. J Perinatol 25, 608–611 (2005). https://doi.org/10.1038/sj.jp.7211357

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.jp.7211357

This article is cited by

Search

Advanced search

Quick links