Breast milk-acquired cytomegalovirus (aCMV) infection with sepsis-like syndrome in extremely preterm twins

Cytomegalovirus (CMV) infection is a common perinatal viral infection. Most CMV infections are asymptomatic; only a part of them present with symptoms, particularly in infants fed fresh breast milk. This article reports a case of two extremely preterm twins who simultaneously developed severe breast milk-acquired CMV infection. By reviewing the medical records of two infants, observing their clinical symptoms, collecting laboratory test results (including blood routine, biochemistry, inflammatory indicators, etc.), and conducting continuous monitoring of CMV-DNA in blood, urine, and breast milk, the research results were obtained. Both infants presented with sepsis-like syndrome: fever, apnea, pneumonia with respiratory failure, neutropenia, and thrombocytopenia, but antibiotic treatment was ineffective. Finally, the diagnosis of breast milk-acquired CMV infection was confirmed by testing of CMV DNA. Severe breast milk-acquired CMV infection occurring simultaneously in preterm twins was extremely rare. In clinical practice, early detection, timely diagnosis, and positive intervention are key points for breast milk-acquired CMV infection.