scholarly journals Congenital Infection and Disorders of Brain Development: With Special Reference to Congenital Cytomegalovirus Infection

1997 ◽  
Vol 37 (1) ◽  
pp. 1-14 ◽  
Author(s):  
Yoshihiro TSUTSUI ◽  
Isao KOSUGI ◽  
Yuichiro SHINMURA ◽  
Masato NAGAHAMA
2009 ◽  
Vol 4 (01) ◽  
pp. 044-047 ◽  
Author(s):  
Zakyieh Al-Hareth ◽  
Fawza Monem ◽  
Nagwa Abdel Megiud

Background: Congenital cytomegalovirus infection is currently the leading cause of congenital infection in 0.2-2.2% of live births worldwide leading to variable serious sequalae. The aim of the study was to determine if low birth weight is an indicator of CMV congenital infection evidenced by detecting CMV-DNA in umbilical cord blood at the time of delivery. Methodology: CMV-IgG and IgM antibodies and CMV-DNAemia were assessed in umbilical cord blood of two hundreds newborns, one hundred of whom had birth weight ≤ 2700 gram and/or head circumference ≤ 32 cm. Results: CMV-IgM was not detected, while CMV-IgG was positive in 80-90% of the two hundreds tested newborns. CMV-DNA was detected in four out of the 200 newborns. One of them was over the adopted weight limit (> 2700 gram). Conclusions: CMV-IgM and IgG antibodies assessment was not a potential discriminative test to identify congenitally infected newborns. In addition, low birth weight and small head circumference at birth failed to predict congenital CMV infection. CMV-DNA detection in umbilical cord blood at the time of delivery using real-time PCR of all newborns is recommended as decisive, rapid and non-invasive test.


PEDIATRICS ◽  
1988 ◽  
Vol 82 (1) ◽  
pp. 100-103
Author(s):  
Nancy D. Binder ◽  
John W. Buckmaster ◽  
Gerda I. Benda

The prenatal and neonatal course of a fetus with cytomegalovirus infection and ascites found on ultrasonographic examination at 27 weeks' gestation is reported. The ascites resolved within 4 weeks and the neonate had evidence only of mild congenital cytomegalovirus infection at birth. The factors predictive of the long-term outcome for an infant with congenital cytomegalovirus infection are reviewed. In this case, the finding that signs of significant disease in the fetus do not necessarily correlate with signs of severe congenital infection in the neonate is reported. It is suggested that prospective data are needed to aid in prediction of the course of fetal cytomegalovirus infection.


2015 ◽  
Vol 36 (4) ◽  
pp. 152
Author(s):  
Bill Rawlinson

It is a great pleasure mixed with some sadness to write this editorial. The entire November issue is around the subject of congenital infection, with the focus on the most common, serious cause of congenital malformation in Australia – congenital cytomegalovirus. Infection with cytomegalovirus (CMV) causes serious disease in children globally, resulting in congenital infections present in ~2000 Australian newborns every year, of whom most are asymptomatic, with ~450 per annum (pa) affected by hearing loss, mental disability and other illnesses. Some of the key clinical features of congenital infection are outlined here in articles by Wendy van Zuylen, Klaus Hamprecht and Robert George, and the pathogenetic features in Lenore Pereira’s paper. Treatment and vaccination are moving ahead (as discussed in papers from some key Italian groups), although not fast enough for many of us – as parents of children with CMV discuss in two papers here. We also include papers on other causes of congenital infection that are much less common than congenital CMV in Australia. Although these are not related to congenital CMV clinically, with very different medical and epidemiological settings, it is important to put congenital CMV in context, as well as to draw attention to other important causes of congenital infection.


2014 ◽  
Vol 7 (4) ◽  
pp. 140-146 ◽  
Author(s):  
Wendy J van Zuylen ◽  
Stuart T Hamilton ◽  
Zin Naing ◽  
Beverly Hall ◽  
Antonia Shand ◽  
...  

Cytomegalovirus is the most common congenital infection causing serious disease in infants. It is the leading infectious cause of sensorineural hearing loss and neurodevelopmental disability in developed countries. Despite the clinical importance of congenital cytomegalovirus, surveys show there is limited awareness and knowledge in the medical and general community about congenital cytomegalovirus infection. This article reviews the clinical features, global epidemiology, transmission and risk factors for cytomegalovirus infections. It also highlights several major advances made in recent years in the diagnosis and prevention of cytomegalovirus infection during pregnancy. Although research is ongoing, no therapy is currently proven to prevent or treat maternal, fetal or neonatal cytomegalovirus infection. Education of women regarding hygiene measures can help prevent cytomegalovirus infection and are currently the best strategy to prevent congenital cytomegalovirus disease.


2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Muhammad Romail Manan ◽  
Hamna Manan

Introduction: Cytomegalovirus (CMV) is a linear, dsDNA virus that is regarded as the prototype of the Betaherpesvirinae subfamily of viruses. It has an established endemic status in certain locations around the globe, and is also reported to be the most prevalently occurring congenital infection in humans. Furthermore, Cytomegalovirus is notorious for being a persistent lifelong pathogen that poses a threat of reactivation as well. Discussion: Congenital cytomegalovirus infection causes numerous ophthalmologic, and neurologic sequelae, and is also known for being the principal reason behind sensorineural hearing loss of non-genetic etiology in neonates. These symptoms, if present, may give rise to a premonition of congenital Cytomegalovirus disease, and so, a diagnosis can be established  through serology, radiology, and  PCR of salivary, urinary, or dried blood spot samples. Timely administration of ganciclovir or valganciclovir has proven to be effective in managing symptomatic cases of congenital CMV. Conclusion: A well-timed delivery of pharmacological and non-pharmacological interventions is necessary to achieve healthy developmental outcomes for the neonate. Moreover, there is still  a need to study the role of antiviral therapy in silent cases since asymptomatic patients are at a risk of developing long-term clinical sequelae as well. Relevance: An estimated 60-90% of women of child-bearing age get infected with Cytomegalovirus, and Congenital CMV disease is reported in 0.2-2.4% of all live births. Therefore, in order to develop effective screening and management protocols, it is vital to educate healthcare professionals regarding the various aspects of this congenital infection.


2013 ◽  
Vol 2 (1-2) ◽  
Author(s):  
Yoshiyuki Nakajima ◽  
Naoki Masaoka ◽  
Tatsuo Yamamoto

AbstractWe describe a case of congenital cytomegalovirus (CMV) infection transmitted by an immunocompetent woman infected before conception with continuous hyper CMV-immunoglobulin M (IgM). A 33-year-old woman whose CMV-IgM levels were stable more than 8 months before conception was referred at 35 gestational weeks due to fetal unilateral cerebral ventriculomegaly. The maternal serum CMV-IgG was 61.7 U/mL, and the CMV-IgM was 3.89 U/mL. An infant girl weighing 2297 g was delivered transvaginally. The neonate was found to have congenital CMV infection. After delivery, the high maternal CMV-IgM level has continued for more than 2 years. In conclusion, although continuous hyper CMV-IgM is rare, the infants of infected women may develop congenital infection. It is our hope that the information provided in the present case will further aid clinicians in counseling patients who find themselves in this situation.


2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S3-S4
Author(s):  
Christian Renaud ◽  
Mina Smiljkovic ◽  
Isabelle Boucoiran ◽  
Silvie Valois ◽  
Bruce Tapiero ◽  
...  

Abstract Background There remains considerable debate on the role of symptomatic, targeted vs. universal screening of newborns for congenital cytomegalovirus infection (cCMV). Here we report on a hospital-based targeted screening program for (1) infants who failed their newborn hearing screen and (2) infants of HIV-infected women, and compare this to the prevalence among infants tested for CMV following clinical suspicion of a congenital infection. Methods In November 2013, the “Programme québécois de dépistage de la surdité chez les nouveau-nés” (PQDSN), a provincially mandated hearing screening program, was implemented at Centre Hospitalier Universitaire Sainte-Justine, a tertiary maternal-child health center in Montreal, Quebec, along with CMV screening for all infants who failed their hearing test (excluding patients in the neonatal intensive care unit). Concurrently, beginning in April 2013, all infants of HIV-infected women were screened for cCMV infection within 48 hours of birth. The birth prevalence of cCMV infection in these targeted populations was compared with the prevalence among newborns tested for a clinical suspicion of cCMV. Results Out of 11 734 newborns screened for hearing through the PQDSN program between April 2014 and March 2018, 536 failed their initial hearing screen and 4 of these newborns tested positive for cCMV infection (0.75%). Out of a total of 130 HIV-exposed newborns born during this period, 116 were screened for cCMV and 3 (2.6%) confirmed positive. An additional 455 newborns were identified by the attending pediatrician as having a risk factor for any congenital infection; of these, 22 (5.3%) tested positive for cCMV. Using these combined methods, a total of 0.24% of newborns enrolled in the PQDSN program tested positive for cCMV infection. Conclusion The overall birth prevalence of cCMV was 0.75% among infants who failed their hearing screen, 2.6% among HIV exposed newborns, and 5.3% among infants with a clinical suspicion of a congenital infection. In the absence of a universal screening program for newborns, these results reinforce the importance of maintaining a high index of clinical suspicion for cCMV infection. Disclosures All authors: No reported disclosures.


PEDIATRICS ◽  
1980 ◽  
Vol 66 (5) ◽  
pp. 758-762 ◽  
Author(s):  
Robert F. Pass ◽  
Sergio Stagno ◽  
Gary J. Myers ◽  
Charles A. Alford

Thirty-four patients with congenital cytomegalovirus infection who were symptomatic as newborns were followed in a special clinic providing periodic medical and visual examinations as well as psychometric testing and audiometry. All patients had symptoms of congenital infection by 2 weeks of age, and 31 of 34 had virus isolated from urine within the first month of life. Age at latest follow-up varied from 9 months to 14 years with a mean of about 4 years. Ten patients died and 23 surviving patients had adequate follow-up examinations; all but two had evidence of central nervous system or auditory handicaps. Microcephaly was present in 16 (70%), mental retardation in 14 (61%), hearing loss in seven (30%), neuromuscular disorders in eight (35%), and chorioretinitis or optic atrophy in five (22%). Children with symptomatic congenital cytomegalovirus infection are at very high risk for handicaps that will significantly impair development.


2020 ◽  
Vol 25 (6) ◽  
pp. 395-395 ◽  
Author(s):  
Michelle Barton ◽  
A Michael Forrester ◽  
Jane McDonald

Abstract Cytomegalovirus (CMV) is the leading cause of congenital infection and the most common cause of non-genetic sensorineural hearing loss (SNHL) in childhood. Although most infected infants are asymptomatic at birth, the risk for SNHL and other neurodevelopmental morbidity makes congenital CMV (cCMV) a disease of significance. Adherence to hygienic measures in pregnancy can reduce risk for maternal CMV infection. The prompt identification of infected infants allows early initiation of surveillance and management. A multidisciplinary approach to management is critical to optimize outcomes in affected infants.


2019 ◽  
Vol 9 (2) ◽  
pp. 116-126
Author(s):  
Md Benzamin ◽  
Md Mizanur Rahman ◽  
Md Rukunuzzaman ◽  
ASM Bazlul Karim

Congenital cytomegalovirus (CMV) infection is the most common congenital infection worldwide and most individuals are eventually exposed to this agent. In developing countries the seroprevalence in women of reproductive age approximates 100%. Cytomegalovirus (CMV) infection has great importance to obstetriciangynecologists and pediatricians. Despite the heavy disease burden, CMV infection is severely under-diagnosed because the majority (approximately 80%) of affected mothers are asymptomatic. The clinical manifestations of congenital CMV infection vary widely, from asymptomatic infection to potentially life-threatening disseminated disease. Prenatal diagnosis of fetal CMV infection can be made by testing amniotic fluid for cytomegalovirus by amniocentesis. Diagnosis of congenital cytomegalovirus infection in neonates should include real-time PCR of saliva, urine, or both, as soon as possible after birth. Antiviral therapy is not routinely recommended for congenital cytomegalovirus infection. Neonates with life-threatening infection and moderately to severely symptomatic congenital cytomegalovirus disease, CNS involvement is considered for immediate treatment that should be initiated within first month of life. J Enam Med Col 2019; 9(2): 116-126


Sign in / Sign up

Export Citation Format

Share Document