Good afternoon members,
I have a strange issue. I have received a 6 weeks old infant, transferred from another hospital, normal vaginal delivery to a G2 P2 mother, with no significant antenatal history(heresay), birth weight being 2.5kg, no other anthropometry available. Baby was discharged but taken to the hospital in view of poor feeding, admitted with a diagnosis of sepsis based on thrombocytopenia(48,000), high CRP but negative culture. Hewas discharged after 5 days of iv cefipime but returned to the hospital after 10 days with breathlessness. He was again investigated, found to be thrombocytopenic and anemic and was transfused with platelets and packed cells, unfortunately using mother's blood. He was also jaundiced (reports not available). The parents got him to our unit at 5.5 weeks, a week after the last transfusion, In our unit, his weight had increased to 2.8 kg, OFC being 33.5cm and length being 47cm. He did not have any petechiae or organomegaly. He is in room air on full feeds. Besides anemia(Hb 10.5 gm%), thrombocytopenia(24,000), Serum bilirubin of 5.5mg% with direct of 3.5mg%, modestly abnormal liver enzymes and a normal CRP. His neurosonogram, abdominal USG and eye examination are normal. He does have sutural overlap. Mother's CMV IgG and IgM are positive.
The problem is how do I rule out congenital CMV infection in this baby at 5.5 weeks who has been transfused recently with mother's own blood products.
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