Congenital CMV: Difference between revisions

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* Mother may have had asymptomatic infection
* Mother may have had asymptomatic infection
* At birth
* At birth
** Microcephaly
** [[Causes::Microcephaly]]
** Periventricular calcifications
** [[Causes::Periventricular calcifications]]
** Chorioretinitis
** [[Causes::Chorioretinitis]]
** Sensorineural hearing loss
** [[Causes::Sensorineural hearing loss]]
** Optic nerve atrophy
** [[Causes::Optic nerve atrophy]]
** Hepatosplenomegaly
** [[Causes::Hepatosplenomegaly]]
** [[Causes::Cytopenias]]
** Cytopenia
* Later
* Later
** Cognitive deficits (7%)
** [[Causes::Cognitive deficits]] (7%)
** Sensorineural hearing loss (20%)
** [[Causes::Sensorineural hearing loss]] (20%)


== Diagnosis ==
== Diagnosis ==

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

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