Comparison of Presentation, Course, and Outcome of Congenital and Acquired Cytomegalovirus Infection in Twins

Abstract

Background Cytomegalovirus (CMV) is one of the most common causes of serious viral intrauterine infections. It is universally distributed among the human population with an average incidence of 0.15 to 2%. Indeed, at least half of the women in the reproductive age have evidence of prior CMV infection. Epidemiology and Pathogenicity However, it is not a usual practice to screen asymptomatic pregnant woman or neonates for CMV. Even if a mother developed a primary CMV infection during pregnancy, up to 90% of the newborns with congenital CMV will be asymptomatic at the time of birth. Only 5 to 7% of the infected babies will be acutely symptomatic, and the typical clinical presentation includes intrauterine growth restriction, microcephaly, various cutaneous manifestations (including petechiae and purpura), hematological abnormalities (particularly resistant thrombocytopenia), hepatosplenomegaly, chorioretinitis, hepatitis, etc. In contrast, acquired CMV infection is extremely unlikely to cause any serious sequelae for the infant. Cases We present a case of congenital and acquired CMV infection in twins with a focus of dissimilarity in presentation, clinical course, and outcome.

Differential congenital cytomegalovirus infection in dichorionic diamniotic twins—A case report and literature review

“…CMV infection in both monochorionic and dichorionic twins can occur in only one fetus or both twins, clinical symptoms and prognosis were quite different ( Table 3 ). In the 21 reported cases of congenital CMV infected twins [2] , [3] , [4] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] , 10 cases (47.6%) were single infant infection, of which 3 cases (30%) were stillborn or died after birth, 2 cases (20%) were terminated. 11 cases (52.3%) were infected with both twins, 1 case of them both twins were stillbirths, one of twins in a case died after birth, twins in a case were terminated.…”

Vertical Transmission and Discordance of Cytomegalovirus in Twin Pregnancies

“…With small numbers, these examinations are considered exploratory. Factors included: sex (possible for DZ twin pairs; Picone et al., 2005 ; Dinkar and Singh, 2020 ); whether the maternal infection was primary or non-primary ( Goncé et al., 2012 ); the gestational age at which the maternal infection occurred ( Samedi et al., 2016 ); prematurity ( Shmueli et al., 2017 ); and fetal growth discordance ( Ahlfors et al., 1988 ). We also examined CMV infection concordance according to whether a MZ twin pair was monochorionic or dichorionic ( Ahlfors et al., 1988 ).…”

Цитомегаловірусний Гепатит У Дітей

“…Поражение печени является характерным для врожденной ЦМВ-инфекции и встречается у 40-63,3 % больных [2,12]. Врожденный ЦМВ-гепатит всегда развивается как первично-хронический процесс.…”

“…Врожденный ЦМВ-гепатит всегда развивается как первично-хронический процесс. Поражение печени сочетается с другими пороками развития: атрезия желчевыводящих путей, формирование цирроза печени, поражение нервной системы, легких, почек [12,13]. В этиологической структуре неонатальных гепатитов ЦМВэтиология составляет до 40 % [14,15].…”