NEW DELHI: A 2 month infant from Uttar Pradesh s Mathura, diagnosed with the first reported case of Rhodoturula infection along with CMV Meningitis, was successfully treated by the team of doctors at Noida s Fortis hospital, said a release by the hospital. The baby was brought in with symptoms of fever, increased irritability and two episodes of abnormal movements, including up rolling of eyes, bulging in the top of head and irritable cry, as per the statement. Several medical tests such as MRI, CSF cerebrospinal fluid were conducted to identify any underlying infection, which revealed that the baby had meningitis. Owing to the uncontrolled seizures, the baby was intubated and administered antibiotics. Clinically, the baby showed improvement with satisfactory feeding and activity, but his high grade fever was not getting better, said a statement released by Fortis hospital. He was having 3 4 episodes of fever every day, thus a CSF examination was repeated and sent for a Biofire test which was CMV positive. Injection Ganciclovir was administered for following six weeks. However, fever didn t subside even after 10 days of IV ganciclovir being administered. The CSF fungal culture revealed the presence of Rhodotorula infection, reported for the first time across the globe, read the statement.
The baby was initially treated with IV antibiotics and IV antiepileptics. However, he had multiple episodes of seizure, for which he was electively intubated and put on mechanical ventilation and IV midazolam infusion. The baby was extubated after 48 hours of being seizure free. Clinically, the baby showed improvement but high grade fever was not getting better. Subsequently, Cytomegalovirus meningitis CMV was detected. The baby was then injected with Ganciclovir which continued for six weeks. However, the fever continued for 10 days. A repeat CSF fungal culture revealed the presence of a rare yeast Rhodotorula species, which has not been identified or observed in CMV anywhere in the world. Then Amphotericin B was started and continued for four weeks, which helped the baby recover and his fever also subsided. Without immediate and correct treatment, the chances of survival were meagre, said Dr Ashutosh Sinha, Director Head, Paediatrics, Fortis Noida. Cytomegalovirus is a common virus and once infected, the body retains the virus for life. Most people don t know they have CMV because it rarely causes problems in healthy people. This infection generally happens in immunocompromised and HIV patients or those undergoing chemotherapy.
There have been cases reported of CMV infection in babies acquired before birth from mother or after birth through breast milk but infection of the brain is very rare. Some babies can acquire it after birth via breast milk.
