Congenital CMV: Difference between revisions
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| β | == |
+ | ==Background== |
| β | * |
+ | *Infection with [[cytomegalovirus]] acquired in utero |
| β | * |
+ | *See also [[CMV in pregnancy]] |
===Epidemiology=== |
===Epidemiology=== |
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*Mother may have had asymptomatic infection |
*Mother may have had asymptomatic infection |
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| β | *At birth |
+ | *At birth (10%) |
| β | **[[Causes::Microcephaly]] |
+ | **[[Causes::Microcephaly]] (35-50%) |
**[[Causes::Periventricular calcifications]] |
**[[Causes::Periventricular calcifications]] |
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| β | **[[Causes:: |
+ | **[[Causes::Seizure]] (5-10%) |
| β | **[[Causes:: |
+ | **[[Causes::Chorioretinitis]] (10-15%) |
| + | **[[Causes::Sensorineural hearing loss]] (35%) |
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**[[Causes::Optic nerve atrophy]] |
**[[Causes::Optic nerve atrophy]] |
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| β | **[[Causes:: |
+ | **[[Causes::Petechiae]] (50-75%) |
| + | **[[Causes::Neonatal jaundice]] (40-70%) |
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| + | **[[Causes::Hepatosplenomegaly]] (40-60%) |
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| + | **Small size for gestational age (40-50%) |
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| + | **[[Causes::Lethargy]] and [[Causes::hypotonia]] (30%) |
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| + | **Poor suck (20%) |
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**[[Causes::Cytopenias]] |
**[[Causes::Cytopenias]] |
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| + | **[[Causes::Hemolytic anemia]] (5-10%) |
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| + | **[[Causes::Pneumonia]] (5-10%) |
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*Later |
*Later |
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**[[Causes::Cognitive deficits]] (7%) |
**[[Causes::Cognitive deficits]] (7%) |
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Revision as of 11:10, 17 August 2020
Background
- Infection with cytomegalovirus acquired in utero
- See also CMV in pregnancy
Epidemiology
- Maternal seroconversion in about 2% of pregnancies
- Higher in childcare workers
- Risk of transmission to fetus
- About 1 in 200 live births in US
- 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 Manifestations
- Mother may have had asymptomatic infection
- At birth (10%)
- Microcephaly (35-50%)
- Periventricular calcifications
- Seizure (5-10%)
- Chorioretinitis (10-15%)
- Sensorineural hearing loss (35%)
- Optic nerve atrophy
- Petechiae (50-75%)
- Neonatal jaundice (40-70%)
- Hepatosplenomegaly (40-60%)
- Small size for gestational age (40-50%)
- Lethargy and hypotonia (30%)
- Poor suck (20%)
- Cytopenias
- Hemolytic anemia (5-10%)
- Pneumonia (5-10%)
- 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.
