PDF(Pubmed)
Abstract：
A late preterm infant with intrauterine growth restriction developed respiratory distress, tachypnoea and hypoxia after birth, requiring supplemental oxygen. Chest radiographs demonstrated persistent elevation of the right hemidiaphragm. Chest ultrasound initially demonstrated symmetrical bilateral diaphragm motion, but subsequent ultrasounds showed asymmetrical excursion with weaker movement of the right hemidiaphragm. Placental pathology demonstrated chronic infectious villitis secondary to cytomegalovirus (CMV), and subsequent CMV testing on the infant was positive. The infant was microcephalic and head imaging revealed intracranial calcifications, consistent with congenital CMV infection.CMV is the most common congenital infection and has a wide array of clinical manifestations. This report highlights the rarely described association between congenital CMV infection and respiratory distress due to underlying diaphragm dysfunction. In neonates with respiratory distress and features of congenital CMV infection, clinicians should have a high index of suspicion for diaphragm dysfunction.
摘要：
宫内生长受限的晚期早产儿出现呼吸窘迫，出生后呼吸急促和缺氧，需要补充氧气。胸部X光片显示右半膈持续升高。胸部超声最初显示对称的双侧膈肌运动，但是随后的超声显示不对称偏移，右半膈运动较弱。胎盘病理显示继发于巨细胞病毒（CMV）的慢性感染性绒毛炎，随后对婴儿的CMV检测呈阳性。婴儿为小头，头部成像显示颅内钙化，符合先天性CMV感染。CMV是最常见的先天性感染，具有广泛的临床表现。该报告强调了先天性CMV感染与潜在的diaphragm肌功能障碍引起的呼吸窘迫之间鲜有描述的关联。在有呼吸窘迫和先天性CMV感染特征的新生儿中，临床医师应高度怀疑膈肌功能障碍.
