Rare etiology of arthrogryposis multiplex congenita at term: congenital cytomegalovirus infection

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Shani Delaney ◽  
Cigdem Ussakli ◽  
Corinne Fligner
Keyword(s):  
Cytomegalovirus Infection ◽  
Arthrogryposis Multiplex Congenita ◽  
Body Parts ◽  
Placental Pathology ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Case Presentation ◽  
Congenital Cytomegalovirus ◽  
Congenital Cmv Infection ◽  
Congenital Cmv

Abstract Background Arthrogryposis multiplex congenita is the presence of multiple congenital contractures of two or more body parts. Congenital cytomegalovirus (CMV) infection is a rare etiology of arthrogryposis. Case presentation We report a case of intrauterine fetal akinesia and arthrogryposis multiplex congenita delivered at term with subsequent neonatal demise. Placental pathology and autopsy revealed congenital CMV infection. Conclusions Evaluation for potential CMV infection is an important part of the arthrogryposis evaluation which is often missed due to lack of maternal infectious symptoms during pregnancy.

Congenital cytomegalovirus infection after maternal persistent immunoglobulin-M antibodies against cytomegalovirus prior to conception

2013 ◽  
Vol 2 (1-2) ◽  
Author(s):  
Yoshiyuki Nakajima ◽  
Naoki Masaoka ◽  
Tatsuo Yamamoto
Keyword(s):  
Cytomegalovirus Infection ◽  
Congenital Infection ◽  
Maternal Serum ◽  
Immunoglobulin M ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Congenital Cmv Infection ◽  
Infant Girl ◽  
Congenital Cmv

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.

Clinical and epidemiological features of congenital cytomegalovirus infection globally

2015 ◽  
Vol 36 (4) ◽  
pp. 153 ◽  
Author(s):  
Wendy J van Zuylen
Keyword(s):  
Vision Loss ◽  
Clinical Importance ◽  
Mental Disability ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Global Epidemiology ◽  
Congenital Cmv Infection ◽  
General Community ◽  
Congenital Cmv

Human cytomegalovirus (CMV) is the most common non-genetic cause of congenital disability. As a herpesvirus that infects the majority of the population, CMV is able to establish a lifelong latent infection in the host. Any time during pregnancy, a primary CMV infection, reactivation of latent CMV or a new viral strain can infect the placenta and the developing foetus, resulting in congenital CMV infection. Each year, an estimated 2000 children are born with congenital CMV infection in Australia, leaving ~500 children with permanent disabilities such as hearing or vision loss, or mental disability. Despite the clinical importance of congenital CMV, there is limited awareness and knowledge in the medical and general community about congenital CMV infection. This article reviews the global epidemiology and clinical features of maternal and congenital CMV infections.

scholarly journals Low total IgM values and high cytomegalovirus loads in the blood of newborns with symptomatic congenital cytomegalovirus infection

2015 ◽  
Vol 43 (2) ◽  
Author(s):  
Yoko Kobayashi ◽  
Ichiro Morioka ◽  
Tsubasa Koda ◽  
Yuji Nakamachi ◽  
Yoko Okazaki ◽  
...  
Keyword(s):  
Immunoglobulin M ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Asymptomatic Group ◽  
Congenital Cytomegalovirus ◽  
Neurological Outcomes ◽  
Symptomatic Group ◽  
Laboratory Markers ◽  
Congenital Cmv Infection ◽  
Congenital Cmv

AbstractNeurological outcomes differ considerably between symptomatic and asymptomatic infants with congenital cytomegalovirus (CMV) infection. Our objective was to characterize laboratory markers in symptomatic newborns in comparison with asymptomatic newborns with congenital CMV infection.Ten newborns with symptomatic and 13 newborns with asymptomatic congenital CMV infection were included in this 3-year prospective cohort study. Total immunoglobulin M (IgM), CMV-IgM, CMV antigenemia, and CMV-DNA in blood and urine were measured and their positive rates and quantitative values compared between the symptomatic and asymptomatic groups.Fifty percent of newborns in the symptomatic group were positive based on total IgM; this was significantly lower than in the asymptomatic group (100%). Quantitative total IgM values were significantly lower, and there were significantly more copies of CMV-DNA in the blood of symptomatic newborns than in asymptomatic newborns (median values for total IgM: 14 vs. 43 mg/dL and blood CMV-DNA: 3.2×10Low total IgM values and high blood CMV loads were associated with the presence of symptoms in newborns with congenital CMV infection.

Child Care Workers and Children with Congenital Cytomegalovirus Infection

PEDIATRICS ◽  
1985 ◽  
Vol 75 (5) ◽  
pp. 971-973
Author(s):  
ROBERT F. PASS ◽  
JANET S. KINNEY
Keyword(s):  
Young Women ◽  
Child Care Workers ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Care Givers ◽  
Child Bearing ◽  
Care Workers ◽  
Congenital Cmv Infection ◽  
Congenital Cmv

Children with congenital cytomegalovirus (CMV) infection shed virus intermittently in saliva and urine for months to years; viruria often persists for five or more years.1 This feature of congenital CMV infection is a problem for institutions such as hospitals and infant developmental centers, as well as for persons who provide care for children with congenital CMV infection. There is concern that these children will transmit CMV to their care givers, who are usually young women in their child-bearing years. Unfortunately, this concern can lead to exclusion of handicapped children with congenital CMV infection from special education programs designed to teach children with motor, hearing or other CNS damage.

Congenital Cytomegalovirus Infection: Diagnostic and Prognostic Significance of the Detection of Specific Immunoglobulin M Antibodies in Cord Serum

PEDIATRICS ◽  
1982 ◽  
Vol 69 (5) ◽  
pp. 544-549
Author(s):  
Paul D. Griffiths ◽  
Sergio Stagno ◽  
Robert F. Pass ◽  
Richard J. Smith ◽  
Charles A. Alford
Keyword(s):  
Cytomegalovirus Infection ◽  
Prognostic Significance ◽  
Immunoglobulin M ◽  
Maternal Infection ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Congenital Infections ◽  
Congenital Cmv Infection ◽  
Specific Immunoglobulin

Specific immunoglobulin M antibodies were detected by radioimmunoassay (RIA-IgM) in cord sera from 83/93 (89%) babies congenitally infected with cytomegalovirus (CMV) but in 0/104 cord sera from uninfected control subjects. The type of maternal infection did not affect the ability of the assay to identify congenital infections, but increased RIA-IgM titers were found more frequently in cord sera from babies infected following primary CMV infections (9/18; 50%) than following recurrent CMV infections (1/12; 8%) (P < .05). The magnitude of the fetal immune response was related to disease inasmuch as 14/40 (35%) babies with increased RIA-IgM titers were symptomatic at birth compared with 1/43 (2%) with lower titers (P < .001). When combined with the results of testing for rheumatoid factor and total IgM, the RIA-IgM assay defined subgroups of babies with generally poor (7/15; 47% symptomatic at any stage) or generally good (0/21 symptomatic) prognoses. Prospective studies currently identifying cases of congenital CMV infection may wish to use these three serologic techniques as the results obtained appear to have prognostic significance for those babies who are initially asymptomatic.

scholarly journals Modern diagnostic and treatment approaches of congenital cytomegalovirus infection: a clinical case

2020 ◽  
pp. 48-54
Author(s):  
O.H. Shadrin ◽  
◽  
A.P. Volokha ◽  
N.H. Chumachenko ◽  
V.M. Fysun ◽  
...  
Keyword(s):  
Cytomegalovirus Infection ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Severe Infection ◽  
Organ Damage ◽  
Antiviral Drugs ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Congenital Cmv Infection

Cytomegalovirus infection (CMV) is one of the most common causes of fetal infection. Recently fetal infections cause from 11% to 45% of perinatal losses, according to various authors, and are considered to be one of the most likely causes of congenital malformations, which lead to infants disability and reduce quality of life. CMV-infection clinical picture is very diverse, disguised as other diseases. There may be clinical manifestations of both generalized infection and single organ damage, because the virus has tropism to various organs and tissues. Timely diagnosis and treatment are the key to successful therapy of even severe manifestations of congenital CMV-infection in infants. Antiviral drugs usage can be sufficiently justified in patients with severe infection and can prevent complications. A clinical case of a manifest form of cytomegalovirus infection with severe hepatitis in an infant is presented and the therapeutic efficacy and safety of the ganciclovir and valganciclovir antiviral drugs are shown. The study is performed in accordance with principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the article. Informed consent of parents was obtained for the research. The authors declare no conflict of interest. Key words: infants, congenital cytomegalovirus infection, ganciclovir, valganciclovir, clinical case.

scholarly journals Update on congenital cytomegalovirus infection: Prenatal prevention, newborn diagnosis, and management

2020 ◽  
Vol 25 (6) ◽  
pp. 395-395 ◽  
Author(s):  
Michelle Barton ◽  
A Michael Forrester ◽  
Jane McDonald
Keyword(s):  
Cytomegalovirus Infection ◽  
Multidisciplinary Approach ◽  
Congenital Infection ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Common Cause ◽  
Hygienic Measures ◽  
Reduce Risk ◽  
Congenital Cmv

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.

scholarly journals Congenital Cytomegalovirus Infection Presenting with Hyperbilirubinemia and Splenomegaly in a Term Infant with Trisomy 21

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Kate Wilson ◽  
Lindsay Ellsworth ◽  
Megan H. Pesch
Keyword(s):  
Early Diagnosis ◽  
Critically Ill ◽  
Trisomy 21 ◽  
Cytomegalovirus Infection ◽  
Term Infant ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Congenital Cmv

Congenital cytomegalovirus infection (cCMV) is very common, yet the presentation can be varied, making the diagnosis challenging. However, early diagnosis for treatment with medication in symptomatic cases within the first month of life is critical. Hyperbilirubinemia and splenomegaly are less common manifestations at birth and may be overlooked in the setting of other symptoms, especially in a critically ill neonate. We present a case of a term infant with trisomy 21 who presented with isolated hyperbilirubinemia and splenomegaly and was later diagnosed with congenital CMV.

Severe fetal anaemia caused by congenital cytomegalovirus infection

2021 ◽  
Vol 14 (10) ◽  
pp. e244585
Author(s):  
Claudia Salazar-Sanchez ◽  
Pedro Llancarí ◽  
Rommy H Novoa ◽  
Walter Ventura
Keyword(s):  
Pregnant Woman ◽  
Fetal Growth ◽  
Umbilical Cord Blood ◽  
Cytomegalovirus Infection ◽  
Peak Systolic Velocity ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Fetal Medicine ◽  
Fetal Infection

A 22-year-old pregnant woman was referred to our fetal medicine unit due to severe fetal growth restriction at 26 weeks of gestation. An extensive detailed ultrasound revealed signs of bilateral periventricular hyperechogenicity, suggesting fetal infection potentially due to cytomegalovirus (CMV). Doppler ultrasound showed a high peak systolic velocity in the middle cerebral artery. Percutaneous umbilical cord blood sampling confirmed fetal CMV infection and severe fetal anaemia. We present this case to highlight the importance of fetal anaemia, which can be fatal regardless of whether it is associated with generalised oedema or hydrops fetalis.

Neonatal screening for congenital cytomegalovirus infection in Tehran, Iran, using Guthrie cards

2020 ◽  
Author(s):  
Samileh Noorbakhsh ◽  
Mohammad Farhadi ◽  
Faezeh Haghighi ◽  
Sara Minaeian ◽  
Morteza Haghighi Hasanabad
Keyword(s):  
Early Stage ◽  
Limited Data ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus ◽  
Congenital Cmv Infection ◽  
Effective Counseling ◽  
Total Dna ◽  
Guthrie Cards ◽  
Congenital Cmv

Background and Objectives: Cytomegalovirus (CMV) constitutes the most common viral cause of congenital infections in newborns worldwide. There are a significant number of asymptomatic newborns with congenital CMV infection in Iran, which may develop long-term sequelae of infection. Unfortunately, limited data exsists from Iran on the rate of congenital CMV infection among neonates. The current study was aimed to investigate the prevalence of congenital CMV infection among Iranian neonates by testing Guthrie cards. Materials and Methods: Guthrie cards were collected from infants within 2 weeks of life, and total DNA was extracted from samples by thermal shock and evaluated for CMV DNA using nested-PCR assay. CMV infection in newborns was confirmed through a commercial CMV PCR kit. Infected infants underwent further evaluation at the hospital. Results: CMV infection was identified in four of 1174 infants (0.34%) which is approximately 3 cases per 1000 live births. Infected infants were asymptomatic at birth and had a normal hearing status similar to other children. There were no factors in relation with CMV infection among newborns. Conclusion: According to the results of this study, infected infants with congenital CMV infection could identify at early stage by testing Guthrie cards (within 21 days of life). Furthermore, since there is a lack of CMV knowledge in our popula- tion, educating and effective counseling by obstetricians/ gynecologists to the pregnant women are recommended.  

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