P386 Acquired lung cysts in a premature infant with congenital cytomegalovirus infection

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Abstract

Introduction

Cystic changes in the lung due to congenital/perinatal cytomegalovirus (CMV) infection have been reported in a few cases in the literature. In this case report, we presented a preterm infant with congenital CMV infection developed lung cysts during her clinical follow-up.

Case

A female neonate was delivered by caesarean section at 35 gestational week due to fetal distress. Her birthweight was 1870 g (10-50th percentile) and Apgar scores 7 and 9, first and fifth minutes, respectively. She was transferred to our intensive care unit because of the prematurity and ventriculomegaly. It was reported that fetal ultrasonography revealed bowel hyperechogenicity at the 18th week of gestation. The serologic examination was negative for CMV IgM. Fetal magnetic resonance imaging was normal and fetal karyotype was 46, XX. The lateral ventricles were observed to be dilated in the repeated ultrasonography performed at 34th week. On physical examination she was well-appearing, there was no abnormality except for hepatosplenomegaly (3 cm below costal margin) and bilateral chorioretinitis. She failed auditory-brainstem-response test. Cranial ultrasonography performed after birth revealed bilateral ventriculomegaly and germinal matrix haemorrhage. Complete blood count showed thrombocytopenia. CMV IgM was reactive and CMV PCR was positive (7.60E+4 cp/mL) in serologic examination. Chest radiography was normal. Intravenous ganciclovir therapy was initiated to the patient at the dose of 12 mg/kg/day due to symptomatic congenital CMV infection. At the postnatal 20th day, a cystic lesion was detected in the basal part of the left lung on the abdomen radiography performed for nutrition intolerance and abdominal distension. Thoracic computed tomography revealed pulmonary cavitary lesions, the largest of them was located in the left lower lobe posterior basal segment. No signs of respiratory distress were detected during this period, infection parameters and blood culture were negative. Cystic lesions in the lung regressed during her clinical follow-up. She was discharged with oral valganciclovir treatment when she was 55 days old.

Conclusion

It should be kept in mind that congenital CMV infection may cause lung cysts.

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