viernes, 21 de diciembre de 2012

Progressive hearing loss following acquired cytomegalovirus infection in an immunocompromised child


We report a rare case of progressive hearing loss after acquired CMV infection in a child with Langerhans cell histiocytosis (LCH).

 A 5-month-old female was diagnosed as having LCH. When she was 14 months old, she received an unrelated donor umbilical cord blood transfusion for the treatment of intractable LCH. 

CMV infection was confirmed after the blood transfusion. 

Because her own umbilical cord had no CMV, the CMV infection was not congenital. 

When she was 7 years old, mixed hearing loss was noted with bilateral otitis media with effusion. 

After that time, the sensorineural hearing loss progressed to bilateral profound hearing loss over 3 years. 

Three-dimensional fluid-attenuated inversion recovery magnetic resonance imaging with gadolinium contrast enhancement revealed a high intensity area in the inner ear that suggested bilateral labyrinthitis. 

 Full-size image (58 K) 3D-FLAIR MRI after intervenous gadolinium administration. 
A was taken when she was 8 years old, and B was when she was 11 years old. 
The gadolinium enhancement of the internal auditory canal indicated by arrows was stronger in B than in A.

 This case demonstrates the possibility that, under the immunodeficiency, the acquired CMV infection causes progressive sensorineural hearing loss.

  • a Department of Otorhinolaryngology, Nagoya University Graduate School of Medicine, 65, Tsurumai-cho, Showa-ku, Nagoya, Japan
  • b Department of Pediatrics, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • c Department of Radiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
  • fuente: American Journal of Otolaryngology.
    Volume 34, Issue 1, January–February 2013, Pages 89–92

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