Congenital CMV: Difference between revisions

Revision as of 20:33, 13 July 2020

Epidemiology

Maternal seroconversion in about 2% of pregnancies
- Higher in childcare workers
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

@@ Line 1: / Line 1: @@
-== Epidemiology ==
+==Epidemiology==
+*Maternal seroconversion in about 2% of pregnancies
-* Risk of transmission to fetus
+**Higher in childcare workers
-** '''Primary infection''': 30% risk of congenital CMV; higher risk later in pregnancy, but worse outcomes earlier
+*Risk of transmission to fetus
-** Non-primary
+**'''Primary infection''': 30% risk of congenital CMV; higher risk later in pregnancy, but worse outcomes earlier
-*** '''Reinfection''': 5% risk
+**Non-primary
-*** '''Reactivation''': 1% risk
+***'''Reinfection''': 5% risk
+***'''Reactivation''': 1% risk
-== Clinical Presentation ==
+==Clinical Presentation==
-* Mother may have had asymptomatic infection
-* At birth
-** [[Causes::Microcephaly]]
-** [[Causes::Periventricular calcifications]]
-** [[Causes::Chorioretinitis]]
-** [[Causes::Sensorineural hearing loss]]
-** [[Causes::Optic nerve atrophy]]
-** [[Causes::Hepatosplenomegaly]]
-** [[Causes::Cytopenias]]
-* Later
-** [[Causes::Cognitive deficits]] (7%)
-** [[Causes::Sensorineural hearing loss]] (20%)
+*Mother may have had asymptomatic infection
-== Diagnosis ==
+*At birth
+**[[Causes::Microcephaly]]
+**[[Causes::Periventricular calcifications]]
+**[[Causes::Chorioretinitis]]
+**[[Causes::Sensorineural hearing loss]]
+**[[Causes::Optic nerve atrophy]]
+**[[Causes::Hepatosplenomegaly]]
+**[[Causes::Cytopenias]]
+*Later
+**[[Causes::Cognitive deficits]] (7%)
+**[[Causes::Sensorineural hearing loss]] (20%)
+==Diagnosis==
-* In mom, IgM antibodies
-* In baby, urine PCR within 2 weeks of birth
+*In mom, IgM antibodies
-== Management ==
+*In baby, urine PCR within 2 weeks of birth
+==Management==
-* Treatment is indicated for symptomatic babies
-** Brain
-** Hearing
-** Eye
-* IV [[Is treated by::ganciclovir]] or PO [[Is treated by::valganciclovir]], for 6 months
-* Monitor CBC while on therapy
+*Treatment is indicated for symptomatic babies
+**Brain
+**Hearing
+**Eye
+*IV [[Is treated by::ganciclovir]] or PO [[Is treated by::valganciclovir]], for 6 months
+*Monitor CBC while on therapy
 [[Category:Pediatrics]]