Congenital and acquired cytomegalovirus infection and hearing evaluation in children

Śmiechura, Małgorzata; Strużycka, Małgorzata; Konopka, Wiesław

doi:10.1016/j.otpol.2014.04.003

Cited by 10 publications

(6 citation statements)

References 20 publications

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“…It can occur immediately after birth in symptomatic CMV infected children, but approximately half of reported cases of hearing loss due to cCMV infection are late-onset and, therefore, cannot always be detected at birth through newborn hearing screening (9). A recent study describes how the timing of seroconversion in primary maternal CMV infection is a strong predictor of postnatal sequelae, with a higher risk when seroconversion occurs in the first trimester rather than later in pregnancy (10).…”

Section: Discussionmentioning

confidence: 99%

Symptomatic Congenital Cytomegalovirus Infection in Children of Seropositive Women

et al. 2017

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Cytomegalovirus (CMV) is the most frequent congenital virus infection worldwide. The risk of congenital CMV (cCMV) transmission is highest in seronegative women who acquire primary CMV infection during pregnancy. A growing body of evidence indicates that secondary CMV infections in pregnant women with preconceptual immunity (either through reactivation of latent virus or re-infection with a new strain of CMV) contribute to a much greater proportion of symptomatic cCMV than was previously thought. Here, we describe a case of symptomatic cCMV infection in the newborn of a woman with proven immunity prior to pregnancy. Diagnosis was confirmed by CMV PCR from amniotic fluid and fetal MR imaging. The newborn presented with typical cCMV symptoms including jaundice, hepatosplenomegaly, cholestasis, petechiae, small head circumference, and sensorineural hearing loss, the most common neurologic sequela. CMV was detected in infant blood and urine by PCR, and intravenous ganciclovir was initiated and continued orally for 6 weeks totally. Apart from persisting right-sided deafness, the child exhibited normal neurological development up through the last follow-up at 4.5 years. To date, the most effective strategy to prevent vertical CMV transmission is hygiene counseling for women of childbearing age, which, in our case, and in concordance with recent literature, applies to seronegative, as well as seropositive, women. Once an expecting mother shows seroconversion or signs of an active CMV infection, there are no established procedures to reduce the risk of transmission, or therapeutic options for the fetus with signs of infection. After birth, symptomatic infants can be treated with ganciclovir to inhibit viral replication and improve hearing ability and neurodevelopmental outcome. A comprehensive review of the literature, including our case study, reveals the most current and significant diagnostic and treatment options available. In conclusion, the triad of maternal hygiene counseling, postnatal hearing screening of all newborns, followed by CMV PCR in symptomatic infants, and antiviral therapy of infants with symptomatic cCMV provides an outline of best practice to reduce the burden of CMV transmission sequelae.

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Section: Discussionmentioning

confidence: 99%

Symptomatic Congenital Cytomegalovirus Infection in Children of Seropositive Women

et al. 2017

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“…De ahí la importancia de la identificación precisa del momento de la infección con la detección por PCR en muestras biológicas de las tres primeras semanas de vida o en la sangre seca de la muestra para metabolopatías, aunque su sensibilidad es menor (aproximadamente del 35 %) por lo que un resultado positivo confirmaría la infección, pero uno negativo no la descartaría totalmente (Demmler-Harrison, 2015) (Smiechura et al, 2014) (Núñez-Ramos et al, 2013). No todos los autores están de acuerdo en la inocuidad de la infección postnatal, por lo que se recomienda seguimiento prolongado de los niños infectados a cualquier edad (Çelikel et al, 2015).…”

Section: Discussionunclassified

Diagnóstico etiológico de la sordera infantil: Recomendaciones CODEPEH 2015

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et al. 2016

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“…In order to differentiate a pre-natal CMV infection from a peri-or post-natal infection (which are not associated to a significant risk of hearing impairment), the CMV DNA research has to be performed within two weeks of birth [23,87,88] . An early diagnosis of congenital CMV infection is fundamental in order to set up the appropriate antiviral therapy [89][90][91] .…”

Section: Diagnostic Work-up Of Moderate-severe Hearing Loss In Childrenmentioning

confidence: 99%

Moderate-Severe Hearing Loss in Children: A Diagnostic and Rehabilitative Challenge

et al. 2017

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Congenital and acquired cytomegalovirus infection and hearing evaluation in children

Abstract: This research proved that CMV infection often caused hearing loss. In spite of this, all children with congenital and acquired CMV should be monitored and assessed throughout their lifetime by an audiologist.

Cited by 10 publications

References 20 publications

Symptomatic Congenital Cytomegalovirus Infection in Children of Seropositive Women

Symptomatic Congenital Cytomegalovirus Infection in Children of Seropositive Women

Diagnóstico etiológico de la sordera infantil: Recomendaciones CODEPEH 2015

Moderate-Severe Hearing Loss in Children: A Diagnostic and Rehabilitative Challenge

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