Department of Pediatrics, Saitama Medical Center, Saitama Medical University, Kawagoe, Saitama, Japan.
Department of Neonatology, Saitama Children's Medical Center, Saitama City, Saitama, Japan.
Pediatr Int. 2022 Jan;64(1):e14994. doi: 10.1111/ped.14994.
Very premature infants are at high risk of developing a symptomatic postnatal cytomegalovirus (CMV) disease, such as CMV-related sepsis-like syndrome (CMV-SLS). To address the limited data regarding its clinical features, a nationwide survey of CMV-SLS was conducted.
A questionnaire regarding CMV status and the clinical outcomes of CMV-SLS was sent to centers with reported cases of CMV-SLS.
Twelve CMV-SLS cases, nine confirmed and three probable cases, were reported during the 3-year survey period. The median gestational age and birthweight were 25 weeks and 547 g, respectively. At disease onset, the median age was 49 days, and the corrected age was 31 weeks. Untreated breast milk was given in four cases (33%), whereas frozen breast milk was given in nine (75%). No specific symptoms and laboratory data regarding CMV-SLS were found.
Very premature infants developed CMV-SLS after 1 month of age. There are no symptoms and signs specific for the diagnosis of CMV-SLS, so CMV-SLS should be considered as a differential diagnosis for premature infants who have unexplained sepsis-like symptoms during the convalescent phase.
极早产儿发生有症状的后天性巨细胞病毒（cytomegalovirus，CMV）感染的风险较高，如 CMV 相关性类似败血症综合征（CMV-related sepsis-like syndrome，CMV-SLS）。为了阐明其临床特征方面的数据有限的问题，进行了一项针对 CMV-SLS 的全国性调查。
向报告有 CMV-SLS 病例的中心发送了一份关于 CMV 状态和 CMV-SLS 临床结局的调查问卷。
在 3 年的调查期间，报告了 12 例 CMV-SLS 病例，其中 9 例确诊，3 例可能。中位胎龄和出生体重分别为 25 周和 547g。在疾病发作时，中位年龄为 49 天，校正年龄为 31 周。4 例（33%）接受了未处理的母乳，9 例（75%）接受了冷冻母乳。未发现针对 CMV-SLS 的特定症状和实验室数据。
极早产儿在 1 个月后发生 CMV-SLS。目前尚无针对 CMV-SLS 的特定诊断症状和体征，因此对于在恢复期出现不明原因类似败血症症状的早产儿，应考虑将 CMV-SLS 作为鉴别诊断。
