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母乳喂养早产儿巨细胞病毒相关性坏死性小肠结肠炎的诊断与预防建议

Recommendations for Diagnosis and Prevention of Cytomegalovirus-Associated Necrotizing Enterocolitis in Breast-Fed Preterm Infants.

作者信息

Pham Jennifer T, Dahlgren Allison F, Rasamimari Phornphat

机构信息

Department of Pharmacy Practice (JTP), University of Illinois at Chicago College of Pharmacy, University of Illinois Hospital & Health Sciences System, Chicago, IL.

University of Chicago (AFD), Comer Children's Hospital, Chicago, IL.

出版信息

J Pediatr Pharmacol Ther. 2022;27(2):180-191. doi: 10.5863/1551-6776-27.2.180. Epub 2022 Feb 9.

Abstract

We present the case of a breast-fed preterm infant with postnatally acquired cytomegalovirus (CMV) and severe necrotizing enterocolitis (NEC) associated with CMV. The infant had persistent severe thrombocytopenia with clinical deterioration despite multiple platelet transfusions and maximal medical treatment. Surgical intervention was not feasible owing to the instability of the infant's condition. Upon identification of CMV in urine, intravenous ganciclovir was initiated with significant clinical improvement. We also present a literature review of cases of CMV-related NEC or other gastrointestinal complications in preterm and term infants.

摘要

我们报告一例母乳喂养的早产婴儿,其出生后获得巨细胞病毒(CMV)感染,并伴有与CMV相关的严重坏死性小肠结肠炎(NEC)。尽管多次输注血小板并进行了最大程度的药物治疗,但该婴儿仍持续存在严重血小板减少症且临床状况恶化。由于婴儿病情不稳定,手术干预不可行。在尿液中检测到CMV后,开始静脉注射更昔洛韦,临床状况有显著改善。我们还对早产和足月婴儿中与CMV相关的NEC或其他胃肠道并发症的病例进行了文献综述。

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引用本文的文献

本文引用的文献

1
Necrotizing Enterocolitis: Enhancing Awareness for the General Practitioner.
Pediatr Rev. 2019 Oct;40(10):517-527. doi: 10.1542/pir.2017-0338.
2
Observational study of cytomegalovirus from breast milk and necrotising enterocolitis.
Arch Dis Child Fetal Neonatal Ed. 2019 Jul 20;105(3):259-65. doi: 10.1136/archdischild-2018-316613.
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The cost of necrotizing enterocolitis in premature infants.
Semin Fetal Neonatal Med. 2018 Dec;23(6):416-419. doi: 10.1016/j.siny.2018.08.004. Epub 2018 Aug 17.
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Cytomegalovirus Enterocolitis in a Term Neonate.
Indian Pediatr. 2018 Feb 15;55(2):163-164.
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Persistent intestinal bleeding due to severe CMV-related thrombocytopenia in a preterm newborn.
J Matern Fetal Neonatal Med. 2018 May;31(9):1246-1249. doi: 10.1080/14767058.2017.1312331. Epub 2017 Apr 11.
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Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy.
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Intestinal manifestations of postnatal and congenital cytomegalovirus infection in term and preterm infants.
J Clin Virol. 2016 Oct;83:29-36. doi: 10.1016/j.jcv.2016.08.289. Epub 2016 Aug 10.

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