Gastrointestinal presentation and outcome of perinatal cytomegalovirus infection

Hendriks, Gillian; McPartland, Jo; El‐Matary, Wael

doi:10.1136/bcr-2012-007671

Cited by 9 publications

(4 citation statements)

References 13 publications

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“…A possible correlation between primary colonic stricture and CMV infection was described in three case reports, 5,52,57 whereas two articles 53,66 reported an association between ileal stricture and CMV enteritis. Post-necrotizing enterocolitis strictures have been described in three reports.…”

Section: Discussionmentioning

confidence: 99%

Neonatal gastrointestinal involvement and congenital cytomegalovirus

et al. 2016

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Cytomegalovirus (CMV) is the most common cause of congenital viral infection, affecting 0.2 to 2.3% of all live births in developed countries. Very low birth weight and extremely low birth weight newborns are at higher risk of symptomatic CMV infection, most commonly secondary and acquired through breast milk. Gastrointestinal involvement is rare in acquired CMV infections, but it could be an important manifestation of postnatal infection in preterm infants admitted to neonatal intensive care units. Early onset of CMV gastrointestinal signs/symptoms is very rare. In a review of the literature it is described in 5 newborns in the first 24 hours of life, and 6 considering the onset in the first week of life. This review describes also a case report of congenital CMV in an immunocompetent newborn with onset of gastrointestinal signs immediately after birth: a possible association between viral infection and enteric manifestations was considered in the differential diagnosis. A review of the literature of the different case reports found has done, with description and comparison of the different patients and clinical presentations. IntroductionCytomegalovirus (CMV) is the most common cause of congenital viral infection, affecting 0.2 to 2.3% of all live births in developed countries; 1-12 it is also estimated as the leading infectious cause of nongenetic hearing loss, mental retardation 1,2,13-15 and non-genetic congenital malformations. 16 Very low birth weight and extremely low birth weight newborns are at higher risk of symptomatic CMV infection, most commonly secondary, acquired through breast milk. 17 Maternal primary CMV infection or reinfection during pregnancy are the cause of neonatal congenital infection, with a mean risk of transmission of 40% (24-75%), 3,18 lower in the first three months (36%) than in the last three months of gestation (78%). 3,19 Considering all the infected newborns, only 5 to 10% are symptomatic at birth, in particular with neurodevelopmental delay signs and sensorial hearing loss. Among asymptomatic patients, 10% to 15% will show developmental disorders, mainly sensory hearing loss. 1,2,8,10,11,13,14,[20][21][22] Most of congenital infections (85-90%) remain asymptomatic: 3,16,23 among them, 8 to 15% will show developmental disorders or sensorial hearing loss. [1][2][3]13,14 Possible signs and symptoms of congenital CMV infection with onset at birth are the following: 3,16,24 unilateral or bilateral sensorial hearing loss, visual loss, microcephaly, hepatomegaly and/or hepatitis, splenomegaly, thrombocytopenia, jaundice, petechiae, motor defects, mental disability, chorioretinitis, strabismus, optic atrophy, dental defects. Rarely it could present as a severe multi organ dysfunction with polyserositis.Gastrointestinal involvement is considered very rare in congenital and acquired CMV infection. 7,8,10,11,20 On the other hand, CMV gastrointestinal symptoms could be an important manifestation of postnatal infection in patients admitted to neonatal intensive care units 25 or a ...

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Section: Discussionmentioning

confidence: 99%

Neonatal gastrointestinal involvement and congenital cytomegalovirus

et al. 2016

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“…Human cytomegalovirus (CMV) can be found in nearly all body secretions, including saliva, urine, breast milk, cervical and vaginal secretions, semen, and blood. Maternal CMV infection can lead to either congenital or perinatal infection in offspring [ 88 ]. GI manifestations of CMV infection are not common, especially in immunocompetent hosts.…”

Section: Pathogens and Ens Development And Diseasementioning

confidence: 99%

“…To date, the detection of viral particles in GI specimens is rarely described in PIPO patients. To our knowledge, there are four case reports describing infants presenting with symptoms that mimic intestinal obstruction [ 88 , 100 , 101 , 102 ]. All patients underwent surgical interventions that showed no evidence of malrotation or organic obstruction, but their intestinal specimens revealed abnormalities in enteric nerves (e.g., hypoganglionosis, thickening of nerve processes) and intranuclear inclusions in enteric neurons.…”

Section: Pathogens and Ens Development And Diseasementioning

confidence: 99%

The Potential Role of Microorganisms on Enteric Nervous System Development and Disease

2023

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The enteric nervous system (ENS), the inherent nervous system of the gastrointestinal (GI) tract is a vast nervous system that controls key GI functions, including motility. It functions at a critical interface between the gut luminal contents, including the diverse population of microorganisms deemed the microbiota, as well as the autonomic and central nervous systems. Critical development of this axis of interaction, a key determinant of human health and disease, appears to occur most significantly during early life and childhood, from the pre-natal through to the post-natal period. These factors that enable the ENS to function as a master regulator also make it vulnerable to damage and, in turn, a number of GI-motility disorders. Increasing attention is now being paid to the potential of disruption of the microbiota and pathogenic microorganisms in the potential aetiopathogeneis of GI-motility disorders in children. This article explores the evidence regarding the relationship between the development and integrity of the ENS and the potential for such factors, notably dysbiosis and pathogenic bacteria, viruses and parasites, to impact upon them in early life.

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“…Congenital cytomegalovirus (CMV) infection is the most common of those [13] and is responsible for numerous perinatal complications such as perinatal mortality, preterm birth, fetal growth restriction, hydrops fetalis, congenital anomalies, neonatal gastrointestinal complications, cerebral hemorrhage, permanent neurological deficits, hearing loss, and visual impairment [14,15,16,17,18,19,20,21,22,23,24,25]. Maternal primary CMV infection is diagnosed in pregnancy based on maternal seroconversion in the 1 st trimester.…”

Section: Introductionmentioning

confidence: 99%

Placental infectious villitis versus villitis of unknown etiology

Stanek¹

2017

pjp

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To assess the incidence, diagnosis, pathogenesis, and clinical and placental associations of congenital cytomegalovirus infection, 34 cases thereof diagnosed by placental/fetal or neonatal workup (group 1), and 494 placentas with villitis of unknown etiology (group 2) were extracted from a 6083-case placental database. 28 clinical and 47 placental phenotypes were compared between the two groups by Yates c 2 or ANOVA using the Bonferroni correction. 26 group 1 cases did and 8 did not feature placental villitis, but all cases were positive as shown by immunohistochemistry and/or in situ hybridization. Only 5 differences were statistically significant (p Bonferroni < 0.0056): gestational age 29.8 ±6.5 vs. 35.5 ±4.9 weeks, perinatal mortality 67.6 vs. 16.2%, nonmacerated stillbirth 20.6 vs. 3.0%, macerated stillbirth 38.2 vs. 9.3%, and diffuse villous fibrosis 44.1 vs. 12.5%, between group 1 and group 2, respectively. The absence of significant differences in placental phenotypes between group 1 and group 2 other than the histological pattern of villitis indicates that not the cytomegalovirus villitis but the direct viral cytopathogenic effect on fetal organs makes the difference in the dire clinical outcome in the former. As about a third of cytomegalovirus infections show no villitis, the combination of the clinical picture and placental patterns creates the best chance to detect congenital cytomegalovirus infection.

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Gastrointestinal presentation and outcome of perinatal cytomegalovirus infection

Cited by 9 publications

References 13 publications

Neonatal gastrointestinal involvement and congenital cytomegalovirus

Neonatal gastrointestinal involvement and congenital cytomegalovirus

The Potential Role of Microorganisms on Enteric Nervous System Development and Disease

Placental infectious villitis versus villitis of unknown etiology

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