Congenital CMV: Difference between revisions
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== Clinical Presentation == |
== Clinical Presentation == |
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* Mother may have had asymptomatic infection |
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* At birth |
* At birth |
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** Microcephaly |
** Microcephaly |
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Revision as of 02:39, 24 October 2019
Epidemiology
- Risk of transmission to fetus
- 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 Presentation
- Mother may have had asymptomatic infection
- At birth
- Microcephaly
- Periventricular calcifications
- Chorioretinitis
- Sensorineural hearing loss
- Optic nerve atrophy
- Hepatosplenomegaly
- Cytopenia
- 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.
