scholarly journals Unexpected hearing improvement after treatment with valganciclovir in a child with congenital cytomegalovirus infection

Folia Medica ◽  
2021 ◽  
Vol 63 (2) ◽  
pp. 297-301
Author(s):  
Silvia Palma ◽  
Laura Mazzoni ◽  
Maria Federica Roversi ◽  
Cecilia Botti ◽  
Daniele Monzani ◽  
...  
Keyword(s):  
Cytomegalovirus Infection ◽  
Hearing Threshold ◽  
Hearing Level ◽  
Late Development ◽  
Hearing Improvement ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Preterm Born ◽  
One Year

A 32-week preterm-born male with symptomatic congenital cytomegalovirus infection was treated with valganciclovir. He was also affected by congenital severe bilateral hearing loss and, unexpectedly, a normalization of the hearing threshold was reached at one year of age. The improvement of hearing level in relationship with both the late development of the auditory system and the administration of antiviral therapy is discussed. This case also highlights the importance of early diagnosis of congenital cytomegalovirus associated with close follow-up.

scholarly journals Hearing Trajectory in Children with Congenital Cytomegalovirus Infection

2018 ◽  
Vol 158 (4) ◽  
pp. 736-744 ◽  
Author(s):  
Tatiana M. Lanzieri ◽  
Winnie Chung ◽  
Jessica Leung ◽  
A. Chantal Caviness ◽  
Jason L. Baumgardner ◽  
...  
Keyword(s):  
White Matter ◽  
Early Onset ◽  
Cytomegalovirus Infection ◽  
Cox Regression ◽  
Hearing Threshold ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Delayed Onset ◽  
Hearing Thresholds ◽  
Asymptomatic Case

Objectives To compare hearing trajectories among children with symptomatic and asymptomatic congenital cytomegalovirus infection through age 18 years and to identify brain abnormalities associated with sensorineural hearing loss (SNHL) in asymptomatic case patients. Study Design Longitudinal prospective cohort study. Setting Tertiary medical center. Subjects and Methods The study included 96 case patients (4 symptomatic and 92 asymptomatic) identified through hospital-based newborn cytomegalovirus screening from 1982 to 1992 and 72 symptomatic case patients identified through referrals from 1993 to 2005. We used growth curve modeling to analyze hearing thresholds (0.5-8 kHz) by ear with increasing age and Cox regression to determine abnormal findings on head computed tomography scan associated with SNHL (hearing threshold ≥25 dB in any audiometric frequency) among asymptomatic case patients. Results Fifty-six (74%) symptomatic and 20 (22%) asymptomatic case patients had SNHL: congenital/early-onset SNHL was diagnosed in 78 (51%) and 10 (5%) ears, respectively, and delayed-onset SNHL in 25 (17%) and 20 (11%) ears; 49 (32%) and 154 (84%) ears had normal hearing. In affected ears, all frequency-specific hearing thresholds worsened with age. Congenital/early-onset SNHL was significantly worse (severe-profound range, >70 dB) than delayed-onset SNHL (mild-moderate range, 26-55 db). Frequency-specific hearing thresholds were significantly different between symptomatic and asymptomatic case patients at 0.5 to 1 kHz but not at higher frequencies (2-8 kHz). Among asymptomatic case patients, white matter lucency was significantly associated with SNHL by age 5 years (hazard ratio, 4.4; 95% CI, 1.3-15.6). Conclusion Congenital/early-onset SNHL frequently resulted in severe to profound loss in symptomatic and asymptomatic case patients. White matter lucency in asymptomatic case patients was significantly associated with SNHL by age 5 years.

scholarly journals Contribution of Congenital Cytomegalovirus Infection to Permanent Hearing Loss in a Highly Seropositive Population: The Brazilian Cytomegalovirus Hearing and Maternal Secondary Infection Study

2019 ◽  
Author(s):  
Aparecida Y Yamamoto ◽  
Adriana R T Anastasio ◽  
Eduardo T Massuda ◽  
Myriam L Isaac ◽  
Alessandra K S Manfredi ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Cytomegalovirus Infection ◽  
Late Onset ◽  
Secondary Infection ◽  
Prevalence Ratio ◽  
Cost Effective ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Newborn Hearing

Abstract Background The exact contribution of congenital cytomegalovirus infection (cCMVI) to permanent hearing loss (HL) in highly seropositive populations is unknown. We determined the contribution of cCMVI to HL and estimated the effectiveness of newborn hearing screening (HS) in identifying neonates with CMV-related HL. Methods A total of 11 900 neonates born from a population with ≥97% maternal seroprevalence were screened for cCMVI and HL. cCMVI was confirmed by detection of CMV-DNA in saliva and urine at age <3 weeks. Results Overall, 68 (0.6%; 95% confidence interval [CI], 0.4–0.7) neonates were identified with cCMVI. Of the 91 (0.8%) newborns who failed the HS, 24 (26.4%) were confirmed with HL, including 7 (29.2%; 95% CI, 17.2–59.3) with cCMVI. Another newborn with cCMVI passed the HS but was confirmed with HL at age 21 days. Of the 62 neonates with cCMVI who underwent a complete hearing evaluation, 8 (12.9%; 95% CI, 6.7–23.4) had HL and most (7/8; 87.5%; 95% CI, 46.6–99.7) were identified by HS. The rate of CMV-related HL was 8 per 11 887 neonates (0.7 per 1000 live births). The prevalence ratio of HL among neonates with cCMVI compared to CMV-uninfected neonates was 89.5 (95% CI, 39.7–202.0). No late-onset cCMVI-related HL was detected during a median follow-up of 36 months. Conclusions cCMVI is an important cause of HL in childhood in all settings. Integrating targeted cCMVI screening among neonates who fail a HS could be a reasonable, cost-effective strategy to identify newborns with early-onset cCMVI-related HL.

scholarly journals 261 Ten-Year follow-Up of Infants with Symptomatic And Asymptomatic Congenital Cytomegalovirus Infection

2012 ◽  
Vol 97 (Suppl 2) ◽  
pp. A76-A76
Author(s):  
M. Capretti ◽  
C. Marsico ◽  
M. Spinelli ◽  
M. D. Angelis ◽  
T. Lazzarotto ◽  
...  
Keyword(s):  
Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus

Outcome of Symptomatic Congenital Cytomegalovirus Infection: Results of Long-Term Longitudinal Follow-up

PEDIATRICS ◽  
1980 ◽  
Vol 66 (5) ◽  
pp. 758-762 ◽  
Author(s):  
Robert F. Pass ◽  
Sergio Stagno ◽  
Gary J. Myers ◽  
Charles A. Alford
Keyword(s):  
Cytomegalovirus Infection ◽  
Neuromuscular Disorders ◽  
Psychometric Testing ◽  
Congenital Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Special Clinic ◽  
Very High

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.

Effect on hearing of ganciclovir therapy for asymptomatic congenital cytomegalovirus infection: four to 10 year follow up

2008 ◽  
Vol 123 (4) ◽  
pp. 391-396 ◽  
Author(s):  
A Lackner ◽  
A Acham ◽  
T Alborno ◽  
M Moser ◽  
H Engele ◽  
...  
Keyword(s):  
Hearing Loss ◽  
Sensorineural Hearing Loss ◽  
Human Cytomegalovirus ◽  
Cytomegalovirus Infection ◽  
Sensorineural Hearing ◽  
Congenital Cytomegalovirus Infection ◽  
Newborn Period ◽  
Congenital Cytomegalovirus ◽  
Ganciclovir Therapy

AbstractBackground:Congenital cytomegalovirus infection is the leading identified nongenetic cause of congenital sensorineural hearing loss. Most of the infections are asymptomatic but may be detected from umbilical cord vein and/or newborn serum positivity for human cytomegalovirus immunoglobulin M, and from urine positivity (on polymerase chain reaction) for human cytomegalovirus deoxyribonucleic acid in the newborn period. Children infected by cytomegalovirus may later develop sensorineural hearing loss. In symptomatically infected infants, ganciclovir therapy administered in the neonatal period prevents hearing deterioration. However, preventative therapy of asymptomatic congenital cytomegalovirus disease with ganciclovir is controversial, as side effects such as severe neutropenia may occur during treatment.Methods:The study population consisted of 23 asymptomatic children with congenital cytomegalovirus infection. Twelve children were treated just after diagnosis of cytomegalovirus infection in the newborn period, with ganciclovir 10 mg/kg bodyweight for 21 days. The other 11 children were observed without therapy. Over a four to 10 year follow-up period, we evaluated all the children's hearing status using pure tone audiometry.Results:All 23 children had normal sensorineural hearing at one year follow up. Five of the 23 children (21.7 per cent) were lost to follow up over the four to 11 year follow-up period. Of the remaining 18 children, sensorineural hearing loss occurred in two (11.1 per cent). Neither child had been treated with ganciclovir in the newborn period. An eight-year-old boy showed bilateral high frequency loss and a 10-year-old girl showed severe unilateral sensorineural hearing loss. In the ganciclovir-treated group (nine children), none showed sensorineural hearing loss. During ganciclovir therapy, moderate neutropenia occurred as a side effect in two out of 12 (16.6 per cent) treated children. Speech and general development were normal in all children.Conclusion:Asymptomatic congenital cytomegalovirus infection is likely to be a leading cause of sensorineural hearing loss in young children. Intravenous ganciclovir therapy seems to offer a medical option to prevent subsequent sensorineural hearing loss. Further studies including a greater number of children are needed. Cytomegalovirus screening models are mandatory if medical therapy is to be implemented in time.

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