Cytomegalovirus as a Seldom Cause of Non-Immune Hydrops Fetalis: Case Report and Review of the Literature

Hydrops fetalis (HF) secondary to cytomegalovirus (CMV) is a rare but potentially fatal entity in neonates. This study aimed at providing data for diagnosis, management, and prevention of CMV associated HF in neonates. Herein, a case of non-immune hydrops fetalis (NIHF) associated with CMV infection is described and a review of the literature is presented.
A female neonate was born at 373/7 weeks of gestational age with clinical findings of HF in Istanbul, Turkey, during year 2015. The infant was admitted to the Neonatal Intensive Care Unit (NICU) due to respiratory distress. The CMV Ig M was positive for both the baby and the mother. Polymerase chain reaction (PCR) demonstrated 6640 copies of CMV in the urine sample. Therefore, CMV infection was considered as the main cause of NIHF and ganciclovir therapy was initiated. As the patient responded well and survived, to the best of our knowledge, this is the first long-term survived case of CMV associated HF.
Congenital CMV infection should be kept in mind as a seldom and life-threatening cause of NIHF. Because serologic tests are not sensitive, antenatal sonographical, postnatal clinical and laboratory findings are crucial for accurate diagnosis and early treatment. All these cautions may be associated with for a better prognosis.