Congenital CMV: Difference between revisions
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== Background == |
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* Infection with [[cytomegalovirus]] acquired in utero |
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* See also [[CMV in pregnancy]] |
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===Epidemiology=== |
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*Maternal seroconversion in about 2% of pregnancies |
*Maternal seroconversion in about 2% of pregnancies |
Revision as of 13:32, 2 August 2020
Background
- Infection with cytomegalovirus acquired in utero
- See also CMV in pregnancy
Epidemiology
- Maternal seroconversion in about 2% of pregnancies
- Higher in childcare workers
- Risk of transmission to fetus
- About 1 in 200 live births in US
- Primary infection: 30% risk of congenital CMV; higher risk later in pregnancy, but worse outcomes earlier
- Non-primary
- Reinfection: 5% risk
- Reactivation: 1% risk
Clinical Manifestations
- Mother may have had asymptomatic infection
- At birth
- Later
- Cognitive deficits (7%)
- Sensorineural hearing loss (20%)
Diagnosis
- In mom, IgM antibodies
- In baby, urine PCR within 2 weeks of birth
Management
- Treatment is indicated for symptomatic babies
- Brain
- Hearing
- Eye
- IV ganciclovir or PO valganciclovir, for 6 months
- Monitor CBC while on therapy
References
- ^ Gisela Enders, Anja Daiminger, Ursula Bäder, Simone Exler, Martin Enders. Intrauterine transmission and clinical outcome of 248 pregnancies with primary cytomegalovirus infection in relation to gestational age. Journal of Clinical Virology. 2011;52(3):244-246. doi:10.1016/j.jcv.2011.07.005.