Congenital cytomegalovirus retinitis of prematurity: a case report and literature review

IntroductionOphthalmopathy induced by cytomegalovirus (CMV) infection is most common in immunodeficient patients without other congenital infections. This paper reports a clinical case of retinitis due to congenital CMV infection in a preterm infant and reviews the relevant literature.Case presentat...

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Main Authors: Yihui Li, Wenqiang Sun, Xinyun Jin, Lei Zhao, Xueping Zhu
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-04-01
Series:Frontiers in Pediatrics
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Online Access:https://www.frontiersin.org/articles/10.3389/fped.2025.1558820/full
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author Yihui Li
Wenqiang Sun
Xinyun Jin
Lei Zhao
Xueping Zhu
author_facet Yihui Li
Wenqiang Sun
Xinyun Jin
Lei Zhao
Xueping Zhu
author_sort Yihui Li
collection DOAJ
description IntroductionOphthalmopathy induced by cytomegalovirus (CMV) infection is most common in immunodeficient patients without other congenital infections. This paper reports a clinical case of retinitis due to congenital CMV infection in a preterm infant and reviews the relevant literature.Case presentationA 2-day-old female infant at 36+2 gestation weeks presented with a 2-day history of scattered bleeding spots across the body, hemorrhagic diathesis, thrombocytopenia, positive blood CMV IgM, and blood and urine CMV DNA levels significantly above the detection limit by PCR analysis. Maternal serological examination indicated blood CMV IgM positivity. The laboratory test results, CMV IgM positivity in the mother's blood was used to confirm a diagnosis of congenital CMV infection. Later, antiviral treatment with ganciclovir was provided for 3 weeks. Fundus examination indicated a few white exudates along the peripheral retina in both eyes, with a white sheath of peripheral retinal vessels above the temporal plane in the right eye. A diagnosis of CMV retinitis was considered after obtaining abnormal fluorescein fundus angiography results. Ganciclovir was administered at 0.5 mg weekly into the vitreous cavities of the eyes for 3 weeks, and the vascular white sheaths disappeared. Retinitis recurred at 6 months of age, and antiviral treatment was recommended. However, the family rejected it.ConclusionCongenital cytomegalovirus retinitis carries substantial risks. For infants suspected of this condition, early initiation of antiviral therapy is crucial to enable timely intervention, improve prognosis, and enhance the child's quality of life.
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spelling doaj-art-2854b248075745db9465019c75d4d1d22025-08-20T03:03:03ZengFrontiers Media S.A.Frontiers in Pediatrics2296-23602025-04-011310.3389/fped.2025.15588201558820Congenital cytomegalovirus retinitis of prematurity: a case report and literature reviewYihui Li0Wenqiang Sun1Xinyun Jin2Lei Zhao3Xueping Zhu4Department of Neonatology, Children’s Hospital of Soochow University, Suzhou, ChinaDepartment of Neonatology, Children’s Hospital of Soochow University, Suzhou, ChinaDepartment of Neonatology, Children’s Hospital of Soochow University, Suzhou, ChinaDepartment of Ophthalmology, Children's Hospital of Soochow University, Suzhou, ChinaDepartment of Neonatology, Children’s Hospital of Soochow University, Suzhou, ChinaIntroductionOphthalmopathy induced by cytomegalovirus (CMV) infection is most common in immunodeficient patients without other congenital infections. This paper reports a clinical case of retinitis due to congenital CMV infection in a preterm infant and reviews the relevant literature.Case presentationA 2-day-old female infant at 36+2 gestation weeks presented with a 2-day history of scattered bleeding spots across the body, hemorrhagic diathesis, thrombocytopenia, positive blood CMV IgM, and blood and urine CMV DNA levels significantly above the detection limit by PCR analysis. Maternal serological examination indicated blood CMV IgM positivity. The laboratory test results, CMV IgM positivity in the mother's blood was used to confirm a diagnosis of congenital CMV infection. Later, antiviral treatment with ganciclovir was provided for 3 weeks. Fundus examination indicated a few white exudates along the peripheral retina in both eyes, with a white sheath of peripheral retinal vessels above the temporal plane in the right eye. A diagnosis of CMV retinitis was considered after obtaining abnormal fluorescein fundus angiography results. Ganciclovir was administered at 0.5 mg weekly into the vitreous cavities of the eyes for 3 weeks, and the vascular white sheaths disappeared. Retinitis recurred at 6 months of age, and antiviral treatment was recommended. However, the family rejected it.ConclusionCongenital cytomegalovirus retinitis carries substantial risks. For infants suspected of this condition, early initiation of antiviral therapy is crucial to enable timely intervention, improve prognosis, and enhance the child's quality of life.https://www.frontiersin.org/articles/10.3389/fped.2025.1558820/fullcongenitalcytomegalovirus infectionretinitisprematurityganciclovir
spellingShingle Yihui Li
Wenqiang Sun
Xinyun Jin
Lei Zhao
Xueping Zhu
Congenital cytomegalovirus retinitis of prematurity: a case report and literature review
Frontiers in Pediatrics
congenital
cytomegalovirus infection
retinitis
prematurity
ganciclovir
title Congenital cytomegalovirus retinitis of prematurity: a case report and literature review
title_full Congenital cytomegalovirus retinitis of prematurity: a case report and literature review
title_fullStr Congenital cytomegalovirus retinitis of prematurity: a case report and literature review
title_full_unstemmed Congenital cytomegalovirus retinitis of prematurity: a case report and literature review
title_short Congenital cytomegalovirus retinitis of prematurity: a case report and literature review
title_sort congenital cytomegalovirus retinitis of prematurity a case report and literature review
topic congenital
cytomegalovirus infection
retinitis
prematurity
ganciclovir
url https://www.frontiersin.org/articles/10.3389/fped.2025.1558820/full
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AT wenqiangsun congenitalcytomegalovirusretinitisofprematurityacasereportandliteraturereview
AT xinyunjin congenitalcytomegalovirusretinitisofprematurityacasereportandliteraturereview
AT leizhao congenitalcytomegalovirusretinitisofprematurityacasereportandliteraturereview
AT xuepingzhu congenitalcytomegalovirusretinitisofprematurityacasereportandliteraturereview