Congenital cytomegalovirus infection-related diaphragmatic dysfunction: A case study

Gad, Yasmin Ahmed; Khalaf, Mohamed Nabeel; Sujay, Narayanaro Krishnamurthy

doi:10.4103/hmj.hmj_38_18

Cited by 2 publications

(4 citation statements)

References 2 publications

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“…This report describes a preterm neonate with fetal growth restriction, intracranial calcifications, thrombocytopenia and mild respiratory distress with associated diaphragm dysfunction in the setting of congenital CMV infection. Four prior reports in the literature describe cases of congenital CMV infection and associated diaphragm dysfunction, with clinical courses ranging from early neonatal death3 4 to survival into infancy with or without need for prolonged mechanical ventilation 5 6. Our report describes a mild clinical course with supplemental oxygen requirement for the first 4 months of life.…”

Section: Discussionmentioning

confidence: 77%

“…It is the leading cause of non-hereditary sensorineural hearing loss (SNHL) and a significant cause of neurodevelopmental delay. Though pneumonitis is a well-known respiratory manifestation of CMV infection, there are few reports in the literature of respiratory distress associated with diaphragm dysfunction in congenital CMV 3–6. Here, we present a neonate with symptomatic congenital CMV infection and respiratory distress associated with diaphragm dysfunction.…”

Section: Introductionmentioning

confidence: 93%

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Congenital CMV associated with diaphragm dysfunction: a rare cause of tachypnoea

et al. 2023

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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.

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Section: Discussionmentioning

confidence: 77%

Section: Introductionmentioning

confidence: 93%

Congenital CMV associated with diaphragm dysfunction: a rare cause of tachypnoea

et al. 2023

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“…A total of 28 articles, encompassing 38 patients, met the inclusion criteria and were included in this systematic review. 3,14,24–49 A detailed flow chart illustrating the study selection process details following the preferred reporting items for systematic reviews and meta-analyses flow diagram is presented in Figure 1. An overview of the characteristics of the included studies is summarized in Table 1.…”

Section: Resultsmentioning

confidence: 99%

“…The pathophysiology of congenital neonatal diaphragmatic dysfunction results from hypoplasia of the diaphragm or impaired nerve innervation. 45 Congenital CMV infection may potentially lead to diaphragmatic paralysis because of the virus interfering with the normal development of the diaphragm muscle, leading to hypoplasia in the diaphragmatic muscle. 34 CMV disrupts neuronal differentiation and migration, impacting the diaphragm muscle cells differentiation, which originate from cervical myotomes during embryogenesis.…”

Section: Table 1 (Continued)mentioning

confidence: 99%

Pulmonary Complications of Cytomegalovirus Infection in Neonates and Infants: A Systematic Review of Case Reports and Pooled Analysis

Ong,

Fan

2024

Pediatric Infectious Disease Journal

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Background: Cytomegalovirus (CMV) causes intrauterine infections in 0.67% of neonates, with 12.7% displaying symptoms at birth. CMV can lead to severe multiorgan involvement, and mortality in symptomatic cases is around 30%. Pulmonary complications are rare in infants with CMV. This review assesses pulmonary complications and outcomes in infants with CMV infection. Methods: A systematic literature search was conducted using PubMed, SCOPUS and Ovid SP to retrieve case reports on pulmonary complications in infants with congenital or perinatal CMV infection. Descriptive analysis and pooled analysis were conducted for the case reports. Results: A total of 28 articles with 38 patients were included in this systematic review. The reported pulmonary complications in the case reports were CMV pneumonitis (34.2%), persistent pulmonary hypertension of the newborn (18.4%), emphysema and chronic lung disease (15.8%), diaphragmatic dysfunction (13.2%), lung cysts and calcifications (10.5%), Pneumocystis jirovecii infection (7.9%), pulmonary hypoplasia (5.3%) and bronchial atresia (2.6%). Seven (18.4%) of 38 patients passed away because of the pulmonary complications of CMV infection. Congenital transmission (P = 0.0108), maternal CMV (P = 0.0396) and presence of neonatal comorbidities (P = 0.0398) were independent risk factors for mortality. Conclusions: This systematic review demonstrated infrequent occurrence of severe pulmonary involvement in CMV infection but should be considered in infants with persistent or severe respiratory symptoms.

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Congenital cytomegalovirus infection-related diaphragmatic dysfunction: A case study

Cited by 2 publications

References 2 publications

Congenital CMV associated with diaphragm dysfunction: a rare cause of tachypnoea

Congenital CMV associated with diaphragm dysfunction: a rare cause of tachypnoea

Pulmonary Complications of Cytomegalovirus Infection in Neonates and Infants: A Systematic Review of Case Reports and Pooled Analysis

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