Fetal ascites owing to congenital cytomegalovirus: response to ganciclovir

Abstract

A term newborn with severe congenital cytomegalovirus (CMV) infection is described. Fetal ascites was detected at 28 weeks gestation, and at birth there was tense ascites. There was intra-uterine growth retardation, microcephaly, chorioretinitis, jaundice, purpura and pneumonitis. Computed tomographic scan of the brain showed ventriculomegaly with periventricular calcifications. Serology was positive for cytomegalovirus-specific immunoglobulin M, and cytomegalovirus DNA was detected in the ascitic fluid and urine by nested polymerase chain reaction. He received 6 weeks of treatment with ganciclovir. Ascites resolved spontaneously and liver function tests became normal. Although there was a good clinical response to ganciclovir therapy without any side-effects, on follow-up the infant had global developmental delay and bilateral sensorineural deafness.

Unusual association of choanal atresia, digital hypoplasia, simian crease, cortical atrophy and hemiparesis with congenital cytomegalovirus infection

“…Systemic drugs approved for treatment of symptomatic CMV infection in neonates are ganciclovir, or its prodrug valganciclovir, foscarnet, and cidofovir. Ganciclovir was the first antiviral agent approved for treatment of CMV disease, and remains the first-line treatment [23].…”