Article Text

CONGENITAL CYTOMEGALOVIRUS: DETECTION AND OUTCOME IN SYMPTOMATIC NEONATES
  1. G S Harrison1,
  2. M A Boyle1,
  3. C F Degascun2,
  4. S J Knowles1,
  5. E J Molloy1
  1. 1National Maternity Hospital, Dublin, Ireland
  2. 2National Virus Refernce Laboratory, University College Dublin, Smithfield, Dublin, Ireland

Abstract

Aim To assess the outcomes of symptomatic congenital cytomegalovirus in babies born between December 2004 and September 2007 in the National Maternity Hospital, Holles Street, Dublin.

Method The National Viral Reference Laboratory database was used to identify babies who tested positive for congenital cytomegalovirus, defined a positive cytomegalovirus culture, DEAFF test or PCR from urine or the presence of cytomegalovirus IgM in blood within 3 weeks of birth. A retrospective chart review was performed to compile clinical details of these patients.

Results 19 521 babies were delivered during the study period. 11 infants were identified with cytomegalovirus infection; eight of these were classified as congenital infection and records were unavailable for one infant. Infants were screened for the following indications: five for intra-uterine growth retardation, one for jaundice, hepatosplenomegaly and petechiae and one as part of screen as infant of a HIV positive mother. Two babies were thrombocytopenic and one had abnormal liver function tests. Six had cranial ultrasound changes suggestive of congenital infection, two of these infants were also microcephalic. Two babies were treated with ganciclovir and three babies died of cytomegalovirus-associated complications. At follow-up, one infant had sensorineural hearing loss identified by audiometry at age 3 months, two had early developmental delay and two infants were lost to follow-up

Conclusion Congenital cytomegalovirus infection represents a significant cause of morbidity worldwide. Early diagnosis of congenital cytomegalovirus in infancy may help to identify neurological and sensory sequelae at a young age, permitting appropriate intervention in early childhood.

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