Allergic colitis in an infant with perinatal cytomegalovirus infection

Abstract

A two month old male presented with a history of bloody, mucous diarrhoea 6 days after the introduction of cow's milk formula. Cow's milk protein allergy was suspected and breast feeding with exclusion of all cow's milk products from his mother's diet was suggested. As a consequence the symptoms disappeared. One month later, when his mother tried to give him again cow's milk formula, diarrhoea with severe rectal bleeding reappeared. A limited colonoscopy was performed suggesting allergic colitis. Despite the exclusion of all cow's milk products from his mother's diet combined with the use of an aminoacid containing formula, diarrhoea and rectal bleeding were not improved. At that time a diagnosis of perinatal cytomegalovirus (CMV) infection was made, based on CMV detection in infant's blood and urine as well as in maternal milk. The symptoms were resolved one week after discontinuation of breast feeding. It is known that CMV can be transmitted from infected mothers to their infants through breastfeeding. However the effect of CMV infected milk in an already fragile mucosa because of the allergic colitis is not well established. Further attention should be given to elucidate a potential interaction between these two conditions.