~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This message is from PedTalk! To reply to the group, use "" ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ I would like to ask some input from the listmembers about a Pakistani baby, we recently investigated for small quantities of blood on the stools. Parents are no blood-relatives. The baby is almost three months, exclusively breastfed, and since one month the parents have noted above problem. Otherwise the baby is doing fine, grows rapidly, birth-history unremarkable. P/E: healthy appearing baby, mild rash in skin-folds, 3 petechiae on abdomen. Stools at present contain no blood. Normal headcircumference, no chorioretinitis. Labarotory investigations reveal isolated thrombocytopenia (around 20, small size, over the last two weeks) and from the urine we cultured CMV. Provisional diagnosis: isolated thrombocytopenia sec. to CMV-infection, probably acquired post-natally. Question: Over the last two weeks the clinical picture improved spontaneously, but when to expect normal number of thrombocytes. Current Dutch medical protocols advise against the use of Ganciclovir (it even may cause thc-penia), would one of you use it (or something else)? Any experiences or suggestions greatly appreciated. Jaap Karsten, General paediatrician The Netherlands