~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ This message is from PedTalk! To reply to the group, use "" ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~ I don't have much experience with using Gangliocivir, but I had some questions about your evaluation. Thrombocytopenia, as you probably know, is part of the TORCHS cluster. Your patient might have a positive CMV culture from pre-natally acquired CMV. Are there any other signs of pre-natally acquired CMV (microcephaly, hepatosplenometally, pneumonia, rash). The importance of distinguishing is that certain consequences of CMV (especially hearing loss) have lifelong implications. When I've tried to make this diagnosis, I've drawn blood for IgM and IgG CMV antibodies. If IgM is negative and IgG is positive you probably have a prenatally acquired infection. If IgM is positive and rising and IgG is negative than you probably have a recent infection. If both are positive, it might be tough to figure although I think that if the IgM were increasing that would probably reflect a recent infection. If doubt arises testing the child's hearing would seem prudent. An excellent source for many of these issues is the Red Book of the American Academy of Pediatrics. I did not consult with this book before writing this, but I often do to get authoritative "state of the art" information. Bob Shayne