CMV-Induced Neonatal Thrombocytopenia: A Case Report and Review of the Literature

Abstract

Cytomegalovirus (CMV) is a member of the Herpesviridae family of DNA viruses. It is unique in its ability to cause latent infection with secondary reactivation. Neonatal infection results from congenital and/or perinatal transmission. We present the case of a full-term infant with petechiae and splenomegaly at birth with no significant antenatal history. She was noted to have thrombocytopenia, but maternal platelet count was normal. Routine workup was normal, which prompted evaluation for toxoplasmosis, other infections, rubella, cytomegalovirus, and herpes simplex (TORCH infection); she was noted to have a positive urine CMV. She received multiple platelet transfusions and after consultation with an infectious disease specialist, she was started on intravenous (IV) ganciclovir. She continued to have persistent thrombocytopenia and received three doses of CMV immunoglobulin with gradual resolution. IV ganciclovir was changed to oral valganciclovir for a total treatment duration of 6 weeks. She failed her hearing screen, but eye examination was normal. She was discharged home after clinical stabilization with a close follow-up.