PDF(Pubmed)
Abstract：
This case report investigates the management of a 24-week-old neonate with congenital cytomegalovirus (CMV) infection and its sequelae, including severe intrauterine growth restriction, thrombocytopenia, and brain anomalies, ultimately progressing to lissencephaly. The diagnostic challenges included delayed clinical suspicion of congenital CMV, which was not identified until after delivery through CMV DNA polymerase chain reaction, and differentiating its symptoms from other potential causes of the neonate\'s condition. Aggressive interventions included antibiotics, antiviral therapy with ganciclovir, and supportive measures such as intubation, CPR, respiratory support, blood transfusions, and management of coagulopathy. Despite these efforts, the patient deteriorated due to progressive hypoperfusion, hypoxemic cardiorespiratory failure, and disseminated intravascular coagulopathy. Due to the poor prognosis and extent of multiorgan damage, support was withdrawn per parental consent. This case highlights the complications encountered when managing an advanced-stage neonatal CMV infection and emphasizes the importance of a multidisciplinary and holistic approach to guide diagnosis and treatment.
摘要：
该病例报告调查了24周龄新生儿先天性巨细胞病毒（CMV）感染及其后遗症的处理，包括严重的宫内生长受限,血小板减少症,和大脑异常，最终进展为脑畸形。诊断挑战包括延迟临床怀疑先天性CMV，直到通过CMVDNA聚合酶链反应递送后才被鉴定出来，并将其症状与新生儿病情的其他潜在原因区分开来。积极的干预措施包括抗生素，更昔洛韦抗病毒治疗，以及插管等支持性措施，CPR,呼吸支持,输血,和凝血功能障碍的管理。尽管做出了这些努力,患者由于进行性灌注不足而恶化，低氧性心肺衰竭，和弥散性血管内凝血病。由于多器官损害的不良预后和程度，根据父母的同意，支持被撤回。该病例强调了管理晚期新生儿CMV感染时遇到的并发症，并强调了多学科和整体方法指导诊断和治疗的重要性。
