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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| β | ** Microcephaly |
+ | ** [[Causes::Microcephaly]] |
| β | ** Periventricular calcifications |
+ | ** [[Causes::Periventricular calcifications]] |
| β | ** Chorioretinitis |
+ | ** [[Causes::Chorioretinitis]] |
| β | ** Sensorineural hearing loss |
+ | ** [[Causes::Sensorineural hearing loss]] |
| β | ** Optic nerve atrophy |
+ | ** [[Causes::Optic nerve atrophy]] |
| β | ** Hepatosplenomegaly |
+ | ** [[Causes::Hepatosplenomegaly]] |
| + | ** [[Causes::Cytopenias]] |
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| β | ** Cytopenia |
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* Later |
* Later |
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| β | ** Cognitive deficits (7%) |
+ | ** [[Causes::Cognitive deficits]] (7%) |
| β | ** Sensorineural hearing loss (20%) |
+ | ** [[Causes::Sensorineural hearing loss]] (20%) |
== Diagnosis == |
== Diagnosis == |
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Revision as of 11:07, 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.
