Severe systemic cytomegalovirus infection of premature infants acquired through breastmilk

Background. Premature infants who acquire cytomegalovirus (CMV) from their seropositive mothers through breastmilk usually develop only mild to modera te symptoms. Case report. We report two cases of extremely low birth weight infants (ELB WI) who got severely ill after CMV-transmission from their mothers. Both sh owed mainly pulmonary symptoms and in one patient high frequency-oscillatio n and nitric oxide-inhalation were administered. There was a strong associa tion between illness and CMV DNA-positive results in breastmilk and cytomeg aloviruria of the infants. Discussion. 93% of CMV IgG-seropositive mothers of premature infants in Ger many have CMV DNA-positive results of their breastmilk. CMV transmission is 59%, about half of the infants become infected. Conclusion. ELBWI can develop serious to life threatening illness after CMV -transmission from their seropositive mothers. Pasteurization of breastmilk to inactivate CMV might be necessary in small and vulnerable premature inf ants.