Yıl 2018, Cilt 16, Sayı 1, Sayfalar 105 - 114 2018-04-01

Prematürelerde Postnatal Sitomegalovirüs Enfeksiyonu

Elif Özalkaya [1] , Özlem Öz [2] , Arzu Akdağ [3] , Sevilay Topçuoğlu [4] , Deniz Çakır [5]

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GİRİŞ: Prematürelerde postnatal CMV (sitomegalovirüs) enfeksiyonu en sık enfekte anne sütü alımı ile kazanılmaktadır. Diğer bulaş yolları perinatal dönemde genital sekresyonlar ve kan transfüzyonudur. Tanı postnatal 3. haftadan sonra idrar, kan ve sekresyonlarda PCR ya da kültür ile virüsün izole edilmesine dayanmaktadır. Term olgularda enfeksiyon çoğunlukla asemptomatiktir. Prematürelerde CMV ilişkili klinik bulgu ve sepsise neden olabilir. Prematüre olgularda CMV ilişkili sepsis az sayıda bildirilmiştir.

OLGU SUNUMU: Olgularımızın her ikisi de 1000 gr altında prematüre idi. C/S ile doğmuşlardı. Premature formulası ile beslenmişler, lökosit filtresi kullanılarak çoklu eritrosit süspansiyonu transfüzyonu almışlardı. İzlemlerinin 2. ayında birinci olguda beslenme intoleransı ve splenomegali, ikinci olguda oksijen ihtiyacında artma ve invaziv ventilasyon ihtiyacı gelişti. Laboratuvar bulgularında her iki olguda karaciğer fonksiyon testlerinde yükselme, kolestaz, trombositopeni ve akut faz yüksekliği saptandı. Kan CMV IgM ve CMV DNA PCR pozitif bulundu. Gansiklovir başlandı. Birinci olgunun 2, ikinci olgunun altı hafta sonunda klinik ve laboratuvar bulguları düzeldi. İzlemlerinde nörolojik sekel ya da işitme kaybı gelişmedi.

TARTIŞMA: Prematürelerde, 3. haftadan sonra gelişen sepsis nedeni olarak postnatal CMV enfeksiyonu akılda tutulmalıdır. 

ABSTRACT

INTRODUCTION: Postnatal CMV (cytomegalovirus) infection in the premature infants is most often transmitted with infected breast milk. The other routes of transmission are blood transfusion and genital secretions. Diagnosis is made by PCR or viral culture of urine, blood, or other body secretions after the first 3 weeks of life. It is mostly asymptomatic in term infants. CMV infection may cause sepsis and many clinical signs in premature infants. There are a few reports of premature infants with CMV sepsis in the literature.

CASE REPORTS: Both of our cases were premature infants weighing less than 1000 g and born with ceaserean section. Since both of the mothers did not have breast milk, infants were fed with premature formula. They were transfused with erythrocyte suspension more than once. The first case has developed feeding intolerance and splenomegaly, the second case had increased oxygen demand and invasive mechanical ventilation support at the end of the second month of life. Laboratory findings showed cholestasis, thrombocytopenia, elevated transaminases and acute phase reactants. Blood CMV IgM and CMV DNA PCR were positive in both cases. Ganciclovir treatment was started. The first case had improvement in clinical and laboratory findings in 2 weeks, the second case had improvement in 6th week of the treatment. None of the patiens developed neurological sequelae or hearing loss.

CONCLUSİON: We aimed to remind that postnatal CMV infection should be suspected in preterm infants who developed sepsis later than fist 3 weeks of life.

postnatal CMV enfeksiyonu, CMV ilişkili sepsis
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Yazar: Elif Özalkaya
E-posta: elifozalkay@gmail.com
Kurum: Bursa Şevket Yılmaz Eğitim ve Araştırma Hastanesi
Ülke: Turkey


Yazar: Özlem Öz
E-posta: elifozalkay@gmail.com
Kurum: Bursa Şevket Yılmaz Eğitim ve Araştırma Hastanesi
Ülke: Turkey


Yazar: Arzu Akdağ
E-posta: elifozalkay@gmail.com
Kurum: Bursa Şevket Yılmaz Eğitim ve Araştırma Hastanesi
Ülke: Turkey


Yazar: Sevilay Topçuoğlu
E-posta: elifozalkay@gmail.com
Kurum: Zeynep Kamil Kadın Doğum ve Çocuk Hastalıkları Hastanesi
Ülke: Turkey


Yazar: Deniz Çakır
E-posta: elifozalkay@gmail.com
Kurum: Şevket Yılmaz Eğitim ve Araştırma Hastanesi,
Ülke: Turkey


Bibtex @olgu sunumu { pediatri411399, journal = {Güncel Pediatri}, issn = {1304-9054}, address = {Uludağ Üniversitesi}, year = {2018}, volume = {16}, pages = {105 - 114}, doi = {}, title = {Prematürelerde Postnatal Sitomegalovirüs Enfeksiyonu}, key = {cite}, author = {Öz, Özlem and Topçuoğlu, Sevilay and Özalkaya, Elif and Çakır, Deniz and Akdağ, Arzu} }
APA Özalkaya, E , Öz, Ö , Akdağ, A , Topçuoğlu, S , Çakır, D . (2018). Prematürelerde Postnatal Sitomegalovirüs Enfeksiyonu. Güncel Pediatri, 16 (1), 105-114. Retrieved from http://dergipark.gov.tr/pediatri/issue/36190/411399
MLA Özalkaya, E , Öz, Ö , Akdağ, A , Topçuoğlu, S , Çakır, D . "Prematürelerde Postnatal Sitomegalovirüs Enfeksiyonu". Güncel Pediatri 16 (2018): 105-114 <http://dergipark.gov.tr/pediatri/issue/36190/411399>
Chicago Özalkaya, E , Öz, Ö , Akdağ, A , Topçuoğlu, S , Çakır, D . "Prematürelerde Postnatal Sitomegalovirüs Enfeksiyonu". Güncel Pediatri 16 (2018): 105-114
RIS TY - JOUR T1 - Prematürelerde Postnatal Sitomegalovirüs Enfeksiyonu AU - Elif Özalkaya , Özlem Öz , Arzu Akdağ , Sevilay Topçuoğlu , Deniz Çakır Y1 - 2018 PY - 2018 N1 - DO - T2 - Güncel Pediatri JF - Journal JO - JOR SP - 105 EP - 114 VL - 16 IS - 1 SN - 1304-9054-1308-6308 M3 - UR - Y2 - 2016 ER -
EndNote %0 Güncel Pediatri Prematürelerde Postnatal Sitomegalovirüs Enfeksiyonu %A Elif Özalkaya , Özlem Öz , Arzu Akdağ , Sevilay Topçuoğlu , Deniz Çakır %T Prematürelerde Postnatal Sitomegalovirüs Enfeksiyonu %D 2018 %J Güncel Pediatri %P 1304-9054-1308-6308 %V 16 %N 1 %R %U