2020 年 79 巻 1 号 p. 41-45
Cytomegalovirus septic shock is rarely reported in a term infant. Case presentation: The patient was a male infant born at full-term and had respiratory distress and low systolic blood pressure. We diagnosed the case as septic shock and initiated treatment with antibiotics, polymyxin Bimmobilized fiber column direct hemoperfusion, and hydrocortisone. However, his overall condition did not improve. We considered cytomegalovirus infection because of the increased number of atypical lymphocytes. Cytomegalovirus DNA was detected in dried umbilical cord. We diagnosed this case as congenital cytomegalovirus infection and started ganciclovir for 3 weeks. He had also been found to have cleft lip, micro penis, and hypoglycemia on admission. MRI of the pituitary gland and glucagon loading test confirmed congenital panhypopituitarism. We treated him with hormone replacement therapy and achieved good growth and improved weight gain thereafter. Conclusions: Our case suggests the need to suspect panhypopituitarism, when hypoglycemia and micro penis are observed in patients with cleft lip. Cytomegalovirus infection should be kept in mind in infants with septic shock
