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http://dx.doi.org/10.14776/piv.2020.27.e19

A Case of Cytomegalovirus Retinitis during Maintenance Chemotherapy for Acute Leukemia  

Ahn, Bin (Department of Pediatrics, Seoul National University Hospital)
Song, Seungha (Department of Pediatrics, Seoul National University Hospital)
Han, Mi Seon (Department of Pediatrics, Seoul National University Hospital)
Oh, Baek Lok (Department of Ophthalmology, Seoul National University Hospital)
Choi, Jae Hong (Department of Pediatrics, Jeju National University Hospital)
Choi, Eun Hwa (Department of Pediatrics, Seoul National University Hospital)
Publication Information
Pediatric Infection and Vaccine / v.27, no.3, 2020 , pp. 198-204 More about this Journal
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.
Keywords
Cytomegalovirus; Retinitis; Chemotherapy;
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