Nephrotic syndrome secondary to cytomegalovirus infection in an extremely preterm neonate
cytomegalovirus. Newborn. Premature infants. PCR. Breast milk.
Cytomegalovirus (CMV) is distributed worldwide and stands out as one of the leading causes of congenital infection, in addition to being an important cause of sensorineural hearing loss in children. In premature newborns, the infection may lead to severe manifestations, such as disseminated sepsis-like disease, hepatic involvement, thrombocytopenia, and cerebral calcifications, among other complications. The aim of this study was to evaluate CMV transmission through breast milk in premature infants and to describe the clinical and laboratory profile of children with congenital and postnatal CMV infection. Urine and breast milk samples were subjected to DNA extraction, followed by a two-step polymerase chain reaction (PCR) that amplifies a fragment of the conserved region of the CMV genome, the major immediate early gene. A total of 150 mothers were included in the study, and the total number of newborns included was 166. Of the 150 mothers, 134 (89.33%) had only reactive anti-CMV IgG, 12 mothers (8%) had non reactive IgM and IgG, and 4 (2.66%) had reactive IgM and IgG for CMV. Congenital infection (positive nested PCR in samples collected up to the third week) was detected in 5 out of 146 newborns analyzed, with a prevalence of 3.4%. The number of perinatal infection cases found was 8 out of 72 newborns analyzed, with a prevalence rate of 11.1%. The age of mothers with positive PCR was lower compared to the group without positive PCR in breast milk. Laboratory and clinical characteristics were compared between the congenital infection, perinatal infection, and uninfected newborn groups, with no significant variation found among the parameters analyzed. At least in the neonatal ICU context, the clinical and laboratory characteristics of newborns infected with CMV through breast milk do not appear to differ from uninfected newborns.