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

Jpn J Infect Dis. 2018 Jul 24;71(4):309-311. doi: 10.7883/yoken.JJID.2017.577. Epub 2018 Apr 27.

Abstract

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.

Keywords: congenital cytomegalovirus infection; ganciclovir; pneumonitis; viral load.

Publication types

  • Case Reports

MeSH terms

  • Administration, Intravenous
  • Adult
  • Antiviral Agents / administration & dosage*
  • Blood / virology
  • Chorioretinitis / congenital
  • Chorioretinitis / drug therapy
  • Chorioretinitis / pathology
  • Chorioretinitis / virology
  • Cytomegalovirus / isolation & purification*
  • Cytomegalovirus Infections / congenital
  • Cytomegalovirus Infections / drug therapy*
  • Cytomegalovirus Infections / pathology
  • Cytomegalovirus Infections / virology
  • DNA, Viral / blood
  • DNA, Viral / urine
  • Drug Monitoring / methods*
  • Female
  • Ganciclovir / administration & dosage*
  • Humans
  • Infant, Newborn
  • Meningoencephalitis / congenital
  • Meningoencephalitis / drug therapy
  • Meningoencephalitis / pathology
  • Meningoencephalitis / virology
  • Pneumonia / congenital
  • Pneumonia / drug therapy*
  • Pneumonia / pathology
  • Pneumonia / virology
  • Real-Time Polymerase Chain Reaction
  • Urine / virology
  • Viral Load*

Substances

  • Antiviral Agents
  • DNA, Viral
  • Ganciclovir