Pediatr Infect Vaccine.  2020 Dec;27(3):198-204. 10.14776/piv.2020.27.e19.

A Case of Cytomegalovirus Retinitis during Maintenance Chemotherapy for Acute Leukemia

Affiliations
  • 1Department of Pediatrics, Seoul National University Hospital, Seoul, the Republic of Korea
  • 2Department of Pediatrics, Seoul National University College of Medicine, Seoul, the Republic of Korea
  • 3Department of Ophthalmology, Seoul National University Hospital, Seoul, the Republic of Korea
  • 4Department of Pediatrics, Jeju National University Hospital, Jeju, the Republic of Korea

Abstract

Cytomegalovirus (CMV) disease is rare in children who receive anticancer chemotherapy and have no history of stem cell transplantation (SCT). We report a case of CMV retinitis that developed during maintenance chemotherapy for acute leukemia. A 7-year-old boy developed decreased visual acuity and persistent pancytopenia during maintenance chemotherapy. Laboratory investigations initially showed significant CMV antigenemia (51 positive cells/200,000 leukocytes); however, antiviral therapy was not deemed necessary in this patient who had no history of SCT. CMV antigenemia worsened to 170 positive cells/200,000 leukocytes over 3 weeks. Ophthalmological examination revealed multiple bilateral retinal infiltrates and granular lesions. He was diagnosed with CMV retinitis and was treated with a 4-week course of intravenous ganciclovir and intravitreal injection of ganciclovir 6 times, followed by a 1-month course of orally administered valganciclovir. A CMV antigenemia assay showed negative results, and follow-up fundoscopy revealed lesser retinal infiltration after the sixth intravitreal ganciclovir injection. Future studies should focus on the development of standardized screening methods and preemptive therapeutic strategies for CMV disease in high-risk children.

Keyword

Cytomegalovirus; Retinitis; Chemotherapy
Full Text Links
  • PIV
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr