Congenital CMV is the leading cause of congenital infections in newborns worldwide and can lead to significant morbidity, mortality, or long-term consequences. Purpose — to demonstrate the results of screening for cytomegalovirus infection of pregnant women and children in the first months of life and illustrate a clinical case of severe congenital CMV and the difficulties in selecting specific therapy. Materials and methods. The article presents the results of a retrospective analysis of CMV testing of 302 pregnant women at living in the Zaporozhye region. The presence of CMV-specific immunoglobulin G (IgG) and M (IgM) antibodies was assessed. In addition, the clinical manifestations of CMV in 56 infants were retrospectively evaluated. A clinical case of congenital CMV in a newborn complicated by hepatitis, nephritis, carditis, pneumonia, thrombocytopenia, was presented. Statistical processing of the results was carried out by the methods of variation statistics. Results. The result of a study of a specific immunological profile for CMV in pregnant women showed that the majority of women of fertile age, residents of Zaporozhye region were seropositive to CMV. In 3% of pregnant women, CMV-specific IgM antibodies was recorded in the blood, which indicates the manifestation of an acute form of CMV and the possibility of infection of the fetus. Prolonged neonatal jaundice was the dominant clinical symptom of congenital CMV in 59.3% patients. The syndrome of perinatal CNS lesion was the second most frequent in these children. In order to illustrate the features of the course, the difficulties of diagnosis and the selection of specific therapy for severe forms of congenital CMV, a clinical case of the corresponding disease was presented. Conclusions. Most women of fertile age are immune to CMV, and 5% of pregnant women have acute primary CMV infection. CMV is the most common cause of congenital infection with substantial morbidity, mortality, and long$term squeal, including sensorineural hearing loss for newborns. Diagnosis of congenital CMV is complicated by both the polysyndromic manifestations of the disease and the lack of a clear system for testing pregnant women and newborns for CMV. The presence of alertness of neonatologists and pediatricians for CMV is a guarantee of timely diagnosis of the disease in newborns. Difficulties in the selection of specific therapy to congenital CMV due to the low sensitivity of the pathogen to acyclovir and the need to use a toxic drug — ganciclovir. Timely administration of highly specific anti-CMV-therapy not only saves the patient's life, but also improve hearing and developmental outcomes. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of these Institutes. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: congenital cytomegalovirus infection, newborns, severe forms, diagnostics, manifestations, treatment.

Zinc (Zn) is an essential trace element that is critical for growth, development and maintenance of immune function. Zn is an indispensable trace element for humans, which is part of more than 20 metalloenzymes, including DNA and RNA polymerase, phosphatase, carbonic anhydrase and some others. The cycle of cell development requires this trace element. The permeability of cell membranes is also related to Zn. It has antioxidant properties and delays the apoptosis of peripheral cells. The formation of immunity depends on the body’s supply of Zn, and its deficiency causes atrophy of the thymic-lymphatic system. Zn is part of insulin, accelerates the regeneration of the mucous layer of the intestines, increases the activity of enzymes of the brush border of enterocytes, increases the level of secretory antibodies and the intensity of cellular immunity. The provision of this element cannot but affect the course of various infectious pathologies. Purpose - by analyzing modern literature data, to find out the importance of Zn provision in infectious pathologies in children. It is analyzed a review of the literature on the pathogenetic role of Zn in the diagnosis, pathogenesis and treatment of infectious diseases, based on a search for articles in the Science, Medline and PubMed databases published from January 2017 to June 2021. An analysis of current literature has shown that Zn is an important micronutrient involved in the regulation of innate and adaptive immune responses. Zn is necessary to ensure the barrier function of membranes. It is involved in the modulation of the pro-inflammatory response. Zn homeostasis is essential for many aspects of the immune system, including hematopoiesis, cell maturation and differentiation, cell cycle progression, and proper immune cell function. Consequently, Zn deficiency leads to cell-mediated immune dysfunctions. Such dysfunctions lead to deterioration of the body's response to bacterial infection. Zn is known to modulate antiviral immunity. Due to zinc, the production of interferon-α is activated and its antiviral activity is increased. Studies show that during the infectious process there is a decrease in the concentration of zinc in the blood plasma. Such changes, on the one hand, provide the needs of immune protection factors, and on the other hand, reduce the availability of the trace element for pathogens. Conclusions. Zn is one of the important trace elements that plays a leading role in maintaining homeostasis and is an integral component of the pathogenesis of various pathological conditions of infectious origin. The most studied is Zn deficiency in infectious diarrhea in children, but studies have been conducted in developing countries with limited resources. No works studying the prevalence of Zn deficiency in Ukraine were found. No conflict of interests was declared by the authors.

The aim — to show the feasibility of using ganciclovir for congenital cytomegalovirus infection (CMVI) by demonstrating two clinical cases. Clinical cases. Over time, the approaches to the treatment of congenital CMVI have changed from the use of acyclovir to the appointment of ganciclovir. In 2011, a premature baby was diagnosed with congenital CMVI based on the presence of multiple organ lesions (lungs, liver, spleen, pancreas, eyes, central nervous system) and positive result of CMV PCR test in blood, urine and cerebrospinal fluid. Only acyclovir was used as an etiotropic drug due to the lack of evidence at that time on the safety of another antiviral drug — ganciclovir. Treatment was not completely effective: in the follow;up at the age of two the child has a grave violation hearing and vision and profound disability due to the residual effects on the central nervous system. In 2019, a newborn child with severe haemorrhagic syndrome, respiratory disorders and neurological symptoms was diagnosed with congenital CMVI by positive result of CMV PCR test and ganciclovir was prescribed at a dose of 6 mg/kg every 12 hours by an intravenous infusion under the control of a routine complete blood count (CBC) test. On the second week of treatment, positive dynamics was observed clinically, on the 6th week — negative result of CMV PCR test. The child was discharged on day 70th of treatment without residual effects on the central nervous system. At the age of 9 months, deafness of 2–3 degrees was diagnosed, but prosthetics were performed timely with complete restoration of hearing. At age of 12 month this child sits, rolls over, crawls; responds adequately to others; captures the gaze and keep an eye on items. Conclusions. Two clinical cases through the description of changes in approaches to specific therapy of congenital cytomegalovirus disease from acyclovir to ganciclovir and a clear demonstration of the difference in disease outcomes — from severe disability when ganciclovir was not prescribed, to complete rehabilitation with its use demonstrate the feasibility of prescribing ganciclovir. The research was carried out in accordance with the principles of the Helsinki Declaration. The informed consent of the patient was obtained for conducting the studies. No conflict of interest was declared by the authors. Key words: congenital cytomegalovirus infection, severe forms, treatment, acyclovir, ganciclovir.