Case Series of Congenital Cytomegalovirus Infection in Neonatal Period

Abstract

Objective: Cytomegalovirus (CMV) is one of the most common cause of congenital infections in the newborn. CMV infection is a multisystem disease, which symptomatic infants generally present with intrauterine growth restriction, hepatosplenomegaly, cholestasis, rash, thrombocytopenia, and microcephaly. Methods: Retrospective chart review was performed for newborns who were diagnosed with congenital CMV infection at tertiary neonatal intensive care unit (NICU) in Turkey, between October 2012 and January 2015. Results: We identified eight cases with congenital CMV infection with an incidence of 0.15 % among admitted neonates. Mean gestational age and birth weight of cases were 32.6 (±4.2) weeks and 1591 (±681) g respectively. Six (75%) cases were premature. The symptoms at presentation were as follows; thrombocytopenia, cholestatic hepatitis, blue-berry muffin rash, intracranial calcification, microcephaly, pneumonia, and bilateral cataract. Five cases were treated with ganciclovir. Three of them died in follow-up. Conclusion: Congenital CMV infection is an important cause of neonatal morbidity and mortality. Physicians should be aware of the preventive measures and postnatal interventions of congenital CMV infection.

Congenital and Perinatal Cytomegalovirus Infections in the Neonatal Period: Case Series

“…Preterm infants (< 32 weeks of gestation) with symptomatic congenital CMV are more likely to have pneumonitis, signs of viral sepsis, thrombocytopenia, and co-infections, and they are less likely to have microcephaly or intracranial calcifications compared to term neonates (2,4,13). In the case series of Ulubas Isik et al, 75% of the cases were preterm (12). In our series, all of the infants were < 37 weeks and 5 of them were < 32 weeks gestation.…”

“…The high rates of estimated incidence in developing countries are associated with the high rates of maternal seroprevalence in these countries (5). The rate of congenital CMV infection from our country was reported as 0.2% (12). In our NICU, parallel to the reports in the literature, the incidence of CMV infection was found to be 0.8%; however, it should be noted that this is the incidence of symptomatic congenital/perinatal CMV infections and CMV screening is not performed routinely in our NICU.…”

“…In the literature, the most common findings associated with the CMV infections in the newborn infants are reported as petechia, jaundice, hepatomegaly, splenomegaly, microcephaly, hearing loss, hypotonia/lethargy, chorioretinitis, and hemolytic anemia (5,6,13). Thrombocytopenia and cholestatic hepatitis were the most common findings in the case series of Ulubas Isik et al whereas prolonged jaundice was the most frequent finding in the series of Çelikel et al (12,14). The most frequent findings in our series were anemia, thrombocytopenia, and hearing loss.…”

Yenidoğan Döneminde Konjenital ve Perinatal Sitomegalovirüs Enfeksiyonu: Olgu Serisi

“…Gelişmekte olan ülkelerdeki tahmini insidansın yüksek oluşu bu ülkelerde görülen yüksek maternal seroprevalansı ile ilişkilidir (5). Ülkemizdeki konjenital CMV enfeksiyon oranı %0.2 olarak bildirilmiştir (12). Literatüre paralel olarak bizim YYBÜ'de CMV enfeksiyonu insidansı %0.8 olarak bulunmuştur ancak bunun semptomatik konjenital/perinatal CMV enfeksiyonlarının insidansı olduğu ve CMV taramasının YYBÜ'de rutin olarak uygulanmadığı dikkate alınmalıdır.…”

“…Literatürde, yenidoğan bebeklerde CMV enfeksiyonu ile ilişkili en yaygın bulgular arasında peteşi, sarılık, hepatomegali, splenomegali, mikrosefali, işitme kaybı, koryoretinit ve hemolitik anemi gösterilmiştir (5,6,13). Ulubaş Işık ve arkadaşlarının olgu serisinde en sık rastlanılan bulgular trombositopeni ve kolestatik hepatit olmuştur (12). Oysa ki Çelikel ve arkadaşlarının serisinde uzamış sarılık en sık görülen bulgu olarak kaydedilmiştir (14).…”