Open AccessOral Gancyclovir Therapy for Immunocompetent Infants With Cytomegalovirus‐associated Hemorrhagic or Intractable Enterocolitis
Author(s) -
Nigro Giovanni,
Pietrobattista Andrea,
Divito Simonetta,
Gambarara Manuela
Publication year - 2010
Publication title -
journal of pediatric gastroenterology and nutrition
Language(s) - English
Resource type - Journals
eISSN - 1536-4801
pISSN - 0277-2116
DOI - 10.1097/mpg.0b013e3181aecb7f
Subject(s) - medicine , cytomegalovirus , enterocolitis , necrotizing enterocolitis , ganciclovir , betaherpesvirinae , enteral administration , valganciclovir , parenteral nutrition , pediatrics , human cytomegalovirus , herpesviridae , gastroenterology , virus , viral disease , immunology
ABSTRACT Three infants, who had prenatal or immediately postnatal cytomegalovirus (CMV) infection associated with persistently severe enterocolitis requiring total parenteral or nasal gastric feeding, were treated with gancyclovir. The intestinal CMV involvement was shown by the detection of CMV‐DNA in the stools of all 3 infants and in the enteral sample from 1 of 2 biopsied infants. Gancyclovir, when given intravenously to the infants, was not followed by CMV clearance or stable clinical improvement. On the contrary, oral gancyclovir that was given for 1‐ to 2‐month courses at the dosage of 70 mg/kg, was associated with clinical improvement or recovery and reintroduction of oral feeding. Cytomegalovirus‐DNA detection became persistently negative in the stools of the infants within 17 months after starting oral gancyclovir. Each child showed normal growth and sensorial, mental, and motor development at the age of 4.7 to 6 years. Oral gancyclovir may be suggested for treatment of CMV‐associated chronic hemorrhagic or intractable enterocolitis.