AN IMMUNOCOMPETENT INFANT WITH COWS MILK ALLERGY AND CYTOMEGALOVIRUS COLITIS

A 5-week-old. severely ill, infant is described with diarrhoea and rec tal bleeding, followed by vomiting and dehydration after introduction of a cow's milk formula. A diagnosis of cow's milk allergy was made be cause of the clinical presentation of an allergic enterocolitis, the r apid improvement after introduction of a hypo-allergenic formula and d evelopment of colic directly after rechallenge with cow's milk. Furthe rmore a highly specific IgE for alpha-lactalbumin strongly supported t he diagnosis. Because of recurrent rectal bleeding a limited colonosco py was performed at the age of 10 weeks. Surprisingly a second diagnos is of histopathologically proven cytomegalovirus (CMV colitis was made . Extensive immunological screening revealed no signs of immunodeficie ncy. The child thrived without any treatment for CMV and developed nor mally. This is the first description of an immunocompetent infant with CMV colitis. Conclusion It cannot be excluded that the allergic colit is facilitated the CMV colitis, or vice versa CMV colitis triggered co w's milk protein induced entero-colitis. Further attention should be g iven to children with bloody diarrhoea to establish a possible relatio nship between CMV infection and cow's milk protein allergy.