Congenital CMV: Difference between revisions
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* Mother may have had asymptomatic infection |
* Mother may have had asymptomatic infection |
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* At birth |
* At birth |
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** Microcephaly |
** [[Causes::Microcephaly]] |
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** Periventricular calcifications |
** [[Causes::Periventricular calcifications]] |
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** Chorioretinitis |
** [[Causes::Chorioretinitis]] |
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** Sensorineural hearing loss |
** [[Causes::Sensorineural hearing loss]] |
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** Optic nerve atrophy |
** [[Causes::Optic nerve atrophy]] |
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** Hepatosplenomegaly |
** [[Causes::Hepatosplenomegaly]] |
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** [[Causes::Cytopenias]] |
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** Cytopenia |
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* Later |
* Later |
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** Cognitive deficits (7%) |
** [[Causes::Cognitive deficits]] (7%) |
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** Sensorineural hearing loss (20%) |
** [[Causes::Sensorineural hearing loss]] (20%) |
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== Diagnosis == |
== Diagnosis == |
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Revision as of 15:07, 8 February 2020
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
- 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 BΓ€der, 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.
- ^ William D Rawlinson, Suresh B Boppana, Karen B Fowler, David W Kimberlin, Tiziana Lazzarotto, Sophie Alain, Kate Daly, Sara DoutrΓ©, Laura Gibson, Michelle L Giles, Janelle Greenlee, Stuart T Hamilton, Gail J Harrison, Lisa Hui, Cheryl A Jones, Pamela Palasanthiran, Mark R Schleiss, Antonia W Shand, Wendy J van Zuylen. Congenital cytomegalovirus infection in pregnancy and the neonate: consensus recommendations for prevention, diagnosis, and therapy. The Lancet Infectious Diseases. 2017;17(6):e177-e188. doi:10.1016/s1473-3099(17)30143-3.
