Audiologic Status of Children with Confirmed Cytomegalovirus Infection: a Case Series

Abstract

Background: Congenital cytomegalovirus (CMV) infection is the most common non-genetic cause of sensorineural hearing loss (SHNL) in children. Only about 10% to 15% of children with congenital CMV are symptomatic, and most are not diagnosed at birth. About 7% to 15% of clinically asymptomatic patients may develop later complications, including SNHL, which is the most common sequela in clinically asymptomatic patients. In this study, hearing status was investigated in children with confirmed CMV infection and neonatal hearing screening (NHS) histories were reviewed to explore hearing loss caused by CMV. Methods: The medical records of 58 children who were diagnosed with confirmed CMV infection were reviewed for clinical symptoms and signs of CMV infection. Hearing status was evaluated with age-appropriate audiological test batteries. Results: A total of 58 children (M:F = 32:26 patients; age at study: mean, 5.62 years, range, 1-10 years) were diagnosed serologically with CMV infection (14 patients, 21.1%), or diagnosed via PCR of serum (5, 7.9%) and/or PCR from urine (19, 26.8%). Hearing loss was confirmed in 11 children (19.0%), being bilateral in 6 (54.5%), and unilateral in 5 (45.5%). Note that 7 of 17 ears with hearing loss passed NHS and were diagnosed only after reevaluation when CMV infection was identified. Conclusion: Hearing loss is a serious complication of CMV infection in children. Our results highlight the importance of timely audiological evaluation in children with clinically symptomatic CMV infection even if they pass NHS.

The Multifaceted Clinical Characteristics of Congenital Cytomegalovirus Infection: From Pregnancy to Long-Term Outcomes

“… 36 Hearing loss may not be present at birth but later progression or fluctuation of hearing have been noted. 37 38 Recent study conducted in Korea proposed the clinical significance of CMV diagnostic test after 3 weeks from birth in children with SNHL. 39 However, the clinical utility of diagnostic strategy is needed to be examined in further research.…”

Congenital Cytomegalovirus and Human Immunodeficiency Virus: Effects on Hearing, Speech and Language Development, and Clinical Outcomes in Children

“…For example, Fletcher et al ( 15 ) found a wide variance (9–68%) in onset time of SNHL based on information from 36 previous studies. In a retrospective case study by Kim et al ( 16 ), 11 out of 58 children (19%) with cCMV had SNHL, but the majority of them were not identified as having hearing loss (HL) during the hospital hearing screening, suggesting SNHL can occur later in life for this population even after passing a newborn hearing screening. Demmler-Harrison et al ( 14 ) studied the long-term effects of cCMV-related HL, finding 20% of asymptomatic cCMV cases born with normal hearing to have late-onset SNHL.…”