Congenital CMV: Difference between revisions

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= Congenital CMV =

== Epidemiology ==
== Epidemiology ==


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* Monitor CBC while on therapy
* Monitor CBC while on therapy



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[[Category:Pediatrics]]

Revision as of 01:35, 16 August 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

  • 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