scholarly journals Modern diagnostic and treatment approaches of congenital cytomegalovirus infection: a clinical case

2020 ◽  
pp. 48-54
Author(s):  
O.H. Shadrin ◽  
◽  
A.P. Volokha ◽  
N.H. Chumachenko ◽  
V.M. Fysun ◽  
...  
Keyword(s):  
Cytomegalovirus Infection ◽  
Clinical Case ◽  
Clinical Manifestations ◽  
Severe Infection ◽  
Organ Damage ◽  
Antiviral Drugs ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Congenital Cmv Infection

Cytomegalovirus infection (CMV) is one of the most common causes of fetal infection. Recently fetal infections cause from 11% to 45% of perinatal losses, according to various authors, and are considered to be one of the most likely causes of congenital malformations, which lead to infants disability and reduce quality of life. CMV-infection clinical picture is very diverse, disguised as other diseases. There may be clinical manifestations of both generalized infection and single organ damage, because the virus has tropism to various organs and tissues. Timely diagnosis and treatment are the key to successful therapy of even severe manifestations of congenital CMV-infection in infants. Antiviral drugs usage can be sufficiently justified in patients with severe infection and can prevent complications. A clinical case of a manifest form of cytomegalovirus infection with severe hepatitis in an infant is presented and the therapeutic efficacy and safety of the ganciclovir and valganciclovir antiviral drugs are shown. The study is performed in accordance with principles of the Declaration of Helsinki. The research protocol was approved by the Local Ethics Committee of the institution mentioned in the article. Informed consent of parents was obtained for the research. The authors declare no conflict of interest. Key words: infants, congenital cytomegalovirus infection, ganciclovir, valganciclovir, clinical case.

Congenital Cytomegalovirus Infection: Diagnostic and Prognostic Significance of the Detection of Specific Immunoglobulin M Antibodies in Cord Serum

PEDIATRICS ◽  
1982 ◽  
Vol 69 (5) ◽  
pp. 544-549
Author(s):  
Paul D. Griffiths ◽  
Sergio Stagno ◽  
Robert F. Pass ◽  
Richard J. Smith ◽  
Charles A. Alford
Keyword(s):  
Cytomegalovirus Infection ◽  
Prognostic Significance ◽  
Immunoglobulin M ◽  
Maternal Infection ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Congenital Infections ◽  
Congenital Cmv Infection ◽  
Specific Immunoglobulin

Specific immunoglobulin M antibodies were detected by radioimmunoassay (RIA-IgM) in cord sera from 83/93 (89%) babies congenitally infected with cytomegalovirus (CMV) but in 0/104 cord sera from uninfected control subjects. The type of maternal infection did not affect the ability of the assay to identify congenital infections, but increased RIA-IgM titers were found more frequently in cord sera from babies infected following primary CMV infections (9/18; 50%) than following recurrent CMV infections (1/12; 8%) (P < .05). The magnitude of the fetal immune response was related to disease inasmuch as 14/40 (35%) babies with increased RIA-IgM titers were symptomatic at birth compared with 1/43 (2%) with lower titers (P < .001). When combined with the results of testing for rheumatoid factor and total IgM, the RIA-IgM assay defined subgroups of babies with generally poor (7/15; 47% symptomatic at any stage) or generally good (0/21 symptomatic) prognoses. Prospective studies currently identifying cases of congenital CMV infection may wish to use these three serologic techniques as the results obtained appear to have prognostic significance for those babies who are initially asymptomatic.

Congenital cytomegalovirus infection after maternal persistent immunoglobulin-M antibodies against cytomegalovirus prior to conception

2013 ◽  
Vol 2 (1-2) ◽  
Author(s):  
Yoshiyuki Nakajima ◽  
Naoki Masaoka ◽  
Tatsuo Yamamoto
Keyword(s):  
Cytomegalovirus Infection ◽  
Congenital Infection ◽  
Maternal Serum ◽  
Immunoglobulin M ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Congenital Cmv Infection ◽  
Infant Girl ◽  
Congenital Cmv

AbstractWe describe a case of congenital cytomegalovirus (CMV) infection transmitted by an immunocompetent woman infected before conception with continuous hyper CMV-immunoglobulin M (IgM). A 33-year-old woman whose CMV-IgM levels were stable more than 8 months before conception was referred at 35 gestational weeks due to fetal unilateral cerebral ventriculomegaly. The maternal serum CMV-IgG was 61.7 U/mL, and the CMV-IgM was 3.89 U/mL. An infant girl weighing 2297 g was delivered transvaginally. The neonate was found to have congenital CMV infection. After delivery, the high maternal CMV-IgM level has continued for more than 2 years. In conclusion, although continuous hyper CMV-IgM is rare, the infants of infected women may develop congenital infection. It is our hope that the information provided in the present case will further aid clinicians in counseling patients who find themselves in this situation.

Rare etiology of arthrogryposis multiplex congenita at term: congenital cytomegalovirus infection

2018 ◽  
Vol 8 (1) ◽  
Author(s):  
Shani Delaney ◽  
Cigdem Ussakli ◽  
Corinne Fligner
Keyword(s):  
Cytomegalovirus Infection ◽  
Arthrogryposis Multiplex Congenita ◽  
Body Parts ◽  
Placental Pathology ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Case Presentation ◽  
Congenital Cytomegalovirus ◽  
Congenital Cmv Infection ◽  
Congenital Cmv

Abstract Background Arthrogryposis multiplex congenita is the presence of multiple congenital contractures of two or more body parts. Congenital cytomegalovirus (CMV) infection is a rare etiology of arthrogryposis. Case presentation We report a case of intrauterine fetal akinesia and arthrogryposis multiplex congenita delivered at term with subsequent neonatal demise. Placental pathology and autopsy revealed congenital CMV infection. Conclusions Evaluation for potential CMV infection is an important part of the arthrogryposis evaluation which is often missed due to lack of maternal infectious symptoms during pregnancy.

scholarly journals Congenital Cytomegalovirus Infection: Evaluation and Management

2019 ◽  
Vol 9 (2) ◽  
pp. 116-126
Author(s):  
Md Benzamin ◽  
Md Mizanur Rahman ◽  
Md Rukunuzzaman ◽  
ASM Bazlul Karim
Keyword(s):  
Cytomegalovirus Infection ◽  
Clinical Manifestations ◽  
Congenital Infection ◽  
Asymptomatic Infection ◽  
Reproductive Age ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Life Threatening ◽  
Disseminated Disease

Congenital cytomegalovirus (CMV) infection is the most common congenital infection worldwide and most individuals are eventually exposed to this agent. In developing countries the seroprevalence in women of reproductive age approximates 100%. Cytomegalovirus (CMV) infection has great importance to obstetriciangynecologists and pediatricians. Despite the heavy disease burden, CMV infection is severely under-diagnosed because the majority (approximately 80%) of affected mothers are asymptomatic. The clinical manifestations of congenital CMV infection vary widely, from asymptomatic infection to potentially life-threatening disseminated disease. Prenatal diagnosis of fetal CMV infection can be made by testing amniotic fluid for cytomegalovirus by amniocentesis. Diagnosis of congenital cytomegalovirus infection in neonates should include real-time PCR of saliva, urine, or both, as soon as possible after birth. Antiviral therapy is not routinely recommended for congenital cytomegalovirus infection. Neonates with life-threatening infection and moderately to severely symptomatic congenital cytomegalovirus disease, CNS involvement is considered for immediate treatment that should be initiated within first month of life. J Enam Med Col 2019; 9(2): 116-126

Severe fetal anaemia caused by congenital cytomegalovirus infection

2021 ◽  
Vol 14 (10) ◽  
pp. e244585
Author(s):  
Claudia Salazar-Sanchez ◽  
Pedro Llancarí ◽  
Rommy H Novoa ◽  
Walter Ventura
Keyword(s):  
Pregnant Woman ◽  
Fetal Growth ◽  
Umbilical Cord Blood ◽  
Cytomegalovirus Infection ◽  
Peak Systolic Velocity ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Fetal Medicine ◽  
Fetal Infection

A 22-year-old pregnant woman was referred to our fetal medicine unit due to severe fetal growth restriction at 26 weeks of gestation. An extensive detailed ultrasound revealed signs of bilateral periventricular hyperechogenicity, suggesting fetal infection potentially due to cytomegalovirus (CMV). Doppler ultrasound showed a high peak systolic velocity in the middle cerebral artery. Percutaneous umbilical cord blood sampling confirmed fetal CMV infection and severe fetal anaemia. We present this case to highlight the importance of fetal anaemia, which can be fatal regardless of whether it is associated with generalised oedema or hydrops fetalis.

Congenital Cytomegalovirus Infection: A Cause of Renal Dysplasia?

2007 ◽  
Vol 10 (4) ◽  
pp. 300-304 ◽  
Author(s):  
Maren Chan ◽  
Jonathan L. Hecht ◽  
Theonia Boyd ◽  
Seymour Rosen
Keyword(s):  
Viral Infections ◽  
Tissue Injury ◽  
Clinical Manifestations ◽  
Renal Dysplasia ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Wide Range ◽  
The Central Nervous System ◽  
Multicystic Dysplasia

Cytomegalovirus (CMV) infection is one of the most frequently encountered viral infections of the fetus and induces a wide range of histologic and clinical manifestations. Congenital abnormalities are typically restricted to the central nervous system despite evidence of CMV inclusions occurring in most epithelial cells. Although tissue injury and even glomerulonephritis have been observed in congenital CMV infections, renal multicystic dysplasia has not been reported. Herein, we describe a case of unilateral renal dysplasia in a 19-week fetus with concurrent CMV infection. We believe the present case to be the first description of a virus apparently inducing renal multicystic dysplasia.

scholarly journals Research Progresses of Congenital Cytomegalovirus Infection

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Rong Tao ◽  
Shiqiang Shang
Keyword(s):  
Cytomegalovirus Infection ◽  
Clinical Manifestations ◽  
Screening Methods ◽  
Prevention Strategies ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Congenital Infections ◽  
Narrative Perspective ◽  
Route Of Transmission ◽  
And Control

Congenital cytomegalovirus infection (cCMVi) in the newborn is one of the most common congenital infections. The children who are infected will present different clinical manifestations. The mild symptoms may be asymptomatic. However, severe cases may have permanent sequelae and even endanger their life. This paper would review the research progresses in the following fields including the epidemiology, the route of transmission, clinical manifestation, screening methods , narrative perspective of prevention and control means. Then the prevention strategies would be summarized.

scholarly journals Congenital cytomegalovirus infection: background for manifestation; clinical case; difficulties of treatment

2021 ◽  
pp. 37-44
Author(s):  
E.V. Usachova ◽  
◽  
E.A. Silina ◽  
T.N. Pakholchuk ◽  
O.V. Konakova ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Cytomegalovirus Infection ◽  
Clinical Case ◽  
Congenital Cytomegalovirus Infection ◽  
Specific Therapy ◽  
Congenital Cytomegalovirus ◽  
Igm Antibodies ◽  
Selection Of ◽  
Congenital Cmv

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.

Clinical and epidemiological features of congenital cytomegalovirus infection globally

2015 ◽  
Vol 36 (4) ◽  
pp. 153 ◽  
Author(s):  
Wendy J van Zuylen
Keyword(s):  
Vision Loss ◽  
Clinical Importance ◽  
Mental Disability ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Global Epidemiology ◽  
Congenital Cmv Infection ◽  
General Community ◽  
Congenital Cmv

Human cytomegalovirus (CMV) is the most common non-genetic cause of congenital disability. As a herpesvirus that infects the majority of the population, CMV is able to establish a lifelong latent infection in the host. Any time during pregnancy, a primary CMV infection, reactivation of latent CMV or a new viral strain can infect the placenta and the developing foetus, resulting in congenital CMV infection. Each year, an estimated 2000 children are born with congenital CMV infection in Australia, leaving ~500 children with permanent disabilities such as hearing or vision loss, or mental disability. Despite the clinical importance of congenital CMV, there is limited awareness and knowledge in the medical and general community about congenital CMV infection. This article reviews the global epidemiology and clinical features of maternal and congenital CMV infections.

scholarly journals Congenital Cytomegalovirus Infection - Lessons from a Clinical Case

Folia Medica ◽  
2020 ◽  
Vol 62 (2) ◽  
pp. 403-407
Author(s):  
Zhivka Stoykova ◽  
Liliya Ivanova ◽  
Snejinka Cvetkova ◽  
Diana Yordanova
Keyword(s):  
Latent Infection ◽  
Clinical Manifestations ◽  
Specific Treatment ◽  
Congenital Infection ◽  
Rt Pcr ◽  
Cmv Infection ◽  
Congenital Cytomegalovirus Infection ◽  
Congenital Cytomegalovirus ◽  
Polymerase Chain ◽  
The Brain

Background: Cytomegalovirus (CMV) is a worldwide spread herpes virus that establishes a latent infection after the primary infection. It becomes a major problem in immunocompromised patients and in cases of primary or reactivated infection during pregnancy. CMV is the most common congenital infection and is the leading infectious cause of sensoneural deafness and cerebral mental retardation. Aim: Тo raise the attention to the discordance in our knowledge of cCMV infection and the implementation of the knowledge in prac­tice. Materials and methods: CMV-DNA was extracted from saliva and plasma samples according to the protocol of DNA-Sorb-A, Sacace, Biotechnologies, Italy. Polymerase chain reaction (PCR) was performed using a commercial kit based on the Taq-man principle: Quantitative RT-PCR for CMV-DNA detection (Sacace, Biotechnologies, Italy). The linear range of the CMV Real-TM Quant PCR test is 500-10000000 copies/ml, and the reported sensitivity is 400 copies/ml. Results: The infant was born with clinical manifestations involving development of hepatosplenomegaly, chorioretinitis, anemia, mi­crocephaly and simultaneous dilatation of the brain ventricles. CMV infection was confirmed using modern PCR studies. Conclusions: This case highlights the need for specific virological/PCR tests to be performed for all children with the least suspected congenital infection, especially when there is an option of a specific treatment.

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