Postnatally acquired cytomegalovirus infection in extremely premature infants: how best to manage?

Arch Dis Child Fetal Neonatal Ed. 2020 May;105(3):334-339. doi: 10.1136/archdischild-2019-317650. Epub 2019 Oct 15.


Postnatal cytomegalovirus (pCMV) infection is a common viral infection typically occurring within the first months of life. pCMV refers to postnatal acquisition of CMV rather than postnatal manifestations of antenatal or perinatal acquired CMV. pCMV is usually asymptomatic in term infants, but can cause symptomatic disease in preterm (gestational age <32 weeks) and very low birth weight (<1500 g) infants resulting in sepsis, pneumonia, thrombocytopaenia, neutropaenia, hepatitis, colitis and occasionally death. There are significant uncertainties regarding the management of premature infants with pCMV disease which is in part due to our limited understanding of the natural history of this disease. This review describes the current epidemiology and clinical manifestations of pCMV disease which should alert clinicians to test for CMV and also outlines a strategy to manage the condition.

Keywords: Postnatal cytomegalovirus; premature infants.

Publication types

  • Review

MeSH terms

  • Antiviral Agents / therapeutic use
  • Cytomegalovirus Infections / diagnosis
  • Cytomegalovirus Infections / drug therapy
  • Cytomegalovirus Infections / epidemiology*
  • Cytomegalovirus Infections / physiopathology*
  • Drug Monitoring
  • Female
  • Humans
  • Infant, Extremely Premature*
  • Infant, Newborn
  • Infant, Premature, Diseases / diagnosis
  • Infant, Premature, Diseases / drug therapy
  • Infant, Premature, Diseases / epidemiology*
  • Infant, Premature, Diseases / physiopathology*
  • Infant, Very Low Birth Weight*
  • Male
  • Neonatal Screening


  • Antiviral Agents