Primary Cytomegalovirus infection in the postnatal period

A male infant born vaginally after a gestation period of 25 4/7 weeks with a birth weight of 875 g underwent surgical correction for oesophageal atresia with a distal tracheo-oesophageal fistula. Postoperative complications included seam leakage, mediastinitis with sepsis, transient elevated diaphragm, recurrent fistula and seam stenosis. Persistent ductus arteriosus was closed surgically. The further course of disease was characterised by periventricular haemorrhage, recurrent infections, bronchopulmonary dysplasia and retinopathy. Anaemia caused by the premature birth and frequent blood sampling necessitated multiple transfusions of filtered, Cytomegalovirus(CMV)-free erythrocyte concentrate. At the age of 3 months, the patient developed cholestatic jaundice that was attributed to a CMV infection contracted through breast milk. The patient recovered spontaneously. At the age of 2 years, the patient had mildly impaired psychomotor development. Reactivation of CMV during lactation is common in CMV-seropositive women. This carries a high risk of transmission of the virus through breast milk, especially for extremely premature neonates. In these infants, an early acquired postnatal CMV infection may lead to serious disorders.