{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T03:32:21Z","timestamp":1783049541683,"version":"3.54.6"},"reference-count":48,"publisher":"American Academy of Pediatrics (AAP)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,11,1]]},"abstract":"<jats:p>Human cytomegalovirus (CMV) infection may be acquired in very low birth weight and extremely low birth weight (ELBW) infants from breast milk. The clinical relevance of such infections is uncertain. There is no consensus on whether screening breast milk for CMV, freezing\/pasteurizing milk before feeding, or performing virological monitoring on at-risk infants is warranted. We describe an ELBW infant who acquired CMV postnatally from breast milk and developed CMV sepsis syndrome and clinical evidence of necrotizing enterocolitis (NEC) at \u223c5 weeks of age. The availability of serial dried blood spots from day of life (DOL) 4 to 21, coincidentally obtained for a metabolic study, provided the novel opportunity to retrospectively test for and quantify the magnitude of CMV DNAemia. DNAemia was present for several weeks before the onset of severe CMV disease, first being noted on DOL 18 and increasing in magnitude daily to 4.8 log10 genomes\/mL on DOL 21, approximately 8 days before the onset of abdominal distension and 15 days before the onset of CMV sepsis syndrome and NEC. After surgical resection, supportive care, and ganciclovir therapy, the infant recovered. This case underscores the importance of including CMV infection in the differential diagnosis of sepsis and NEC in premature infants. This case also suggests the value of prospective virological monitoring in at-risk low birth weight and ELBW infants. Future studies should examine the potential utility of preemptive monitoring for, and possibly treatment of, CMV DNAemia in premature infants, which may herald the onset of serious disease.<\/jats:p>","DOI":"10.1542\/peds.2013-0087","type":"journal-article","created":{"date-parts":[[2013,10,22]],"date-time":"2013-10-22T00:48:33Z","timestamp":1382402913000},"page":"e1428-e1434","source":"Crossref","is-referenced-by-count":26,"title":["Asymptomatic DNAemia Heralds CMV-Associated NEC: Case Report, Review, and Rationale for Preemption"],"prefix":"10.1542","volume":"132","author":[{"given":"Supatida","family":"Tengsupakul","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Amplatz Children\u2019s Hospital and University of Minnesota Medical School, Minneapolis, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole D.","family":"Birge","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Amplatz Children\u2019s Hospital and University of Minnesota Medical School, Minneapolis, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine M.","family":"Bendel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Amplatz Children\u2019s Hospital and University of Minnesota Medical School, Minneapolis, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robyn C.","family":"Reed","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Amplatz Children\u2019s Hospital and University of Minnesota Medical School, Minneapolis, Minnesota; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth-Ann","family":"Bloom","sequence":"additional","affiliation":[{"name":"Minnesota Department of Health, Newborn Screening Program, 601 North Robert Street, St Paul, 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