Role of Magnetic Resonance Imaging and Cranial Ultrasonography in Congenital Cytomegalovirus Infection

Blázquez‐Gamero, Daniel; Soriano-Ramos, María; Aragón, Ana Martínez de; Baquero-Artigao, Fernando; Frick, Marie Antoinette; Noguera-Julián, Antoni; Alonso‐Ojembarrena, Almudena; Calderón, Elisenda Moliner; Ferreiro, María Teresa Rives; Posse, Ana Filgueira; Llanos, Elisa Garrote; Busselo, I. Sota; Santos, Mar; García, Alfredo Tagarro; Bustamante, Jorge; Soler‐Palacín, Pere; Guasch, Claudia Fortuny; Conejo, Pablo Rojo

doi:10.1097/inf.0000000000002455

Cited by 17 publications

(47 citation statements)

References 21 publications

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“…Recent studies report imaging abnormalities of 0%–33% in ‘asymptomatic’ and 64%–76% in ‘symptomatic’ cCMV 24 25. Blazquez-Gamero et al found 69% cUS and/or MRI abnormalities in a cohort of 107 mostly ‘symptomatic’ (72%) subjects, while Lucignani et al reported 79.5% MRI abnormalities in a smaller cohort with 27 of 44 (61.3%) ‘symptomatic’ subjects 26 27. However, data on neuroimaging findings in infants with isolated HL are scarce.…”

Section: Discussionmentioning

confidence: 99%

Targeted screening for congenital cytomegalovirus infection: clinical, audiological and neuroimaging findings

Chung

Schornagel

Oudesluys‐Murphy

et al. 2022

Arch Dis Child Fetal Neonatal Ed

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ObjectiveTo evaluate clinical, audiological and neuroimaging findings in a cohort of infants diagnosed with congenital cytomegalovirus (cCMV) infection after failure at newborn hearing screening.MethodsA prospective observational study in the Netherlands, using the existing newborn hearing screening infrastructure for well babies. Between July 2012 and November 2016, cytomegalovirus (CMV) PCR testing of neonatally obtained dried blood spots (DBS) was offered to all infants who failed newborn hearing screening. Clinical, neuroimaging and audiological data were collected.ResultsDBS of 1374 infants were successfully tested and 59 were positive for CMV (4.3%). Data of 54 infants were retrieved. Three were small for gestational age and six had microcephaly. Forty-eight (89%) had sensorineural hearing loss (SNHL), of whom half had unilateral SNHL. In both unilaterally and bilaterally affected children, the majority of the impaired ears had severe or profound hearing loss. Neuroimaging abnormalities were found in 40 of 48 (83%) children who had evaluable cranial ultrasound and/or cerebral MRI. The abnormalities were mild in 34, moderate in 3 and severe in 3 infants. The degree of SNHL and the severity of neuroimaging abnormalities were found to be correlated (p=0.002).ConclusionsThe yield of targeted cCMV screening following newborn hearing screening failure was eight times higher than the estimated national birth prevalence of cCMV. The majority of this cohort of infants with clinically unsuspected cCMV disease had confirmed SNHL, neuroimaging abnormalities and lower than average birth weights and head circumferences. Newborns who fail newborn hearing screening should be tested for CMV to ensure appropriate clinical, neurodevelopmental and audiological follow-up.

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Section: Discussionmentioning

confidence: 99%

Targeted screening for congenital cytomegalovirus infection: clinical, audiological and neuroimaging findings

Chung

Schornagel

Oudesluys‐Murphy

et al. 2022

Arch Dis Child Fetal Neonatal Ed

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“…Of these, ventriculomegaly and microcephaly are associated with the worst fetal prognosis. The mild cerebral findings related to fetal involvement include ventriculomegaly enlargement (10 to 15 mm) ( Figure 3 ), intracranial calcifications ( Figure 4 ), cysts of the choroid plexus, subependymal cysts, and intraventricular synechiae [ 62 , 63 ].…”

Section: Resultsmentioning

confidence: 99%

An Overview of Cytomegalovirus Infection in Pregnancy

et al. 2022

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The objective of this review was to bring to attention cytomegalovirus (CMV) infection during pregnancy, taking into consideration all relevant aspects, such as maternal diagnosis, fetal infection and prevention, prenatal diagnosis, and postnatal prognosis. A literature review was performed regarding adult and congenital infection. General information regarding this viral infection and potential related medical conditions was provided, considering the issues of maternal infection during pregnancy, transmission to the fetus, and associated congenital infection management. Prenatal diagnosis includes maternal serum testing and the confirmation of the infection in amniotic fluid or fetal blood. Additionally, prenatal diagnosis requires imaging techniques, ultrasound, and complementary magnetic resonance to assess cortical and extracortical anomalies. Imaging findings can predict both fetal involvement and the postnatal prognosis of the newborn, but they are difficult to assess, even for highly trained physicians. In regard to fetal sequelae, the early diagnosis of a potential fetal infection is crucial, and methods to decrease fetal involvement should be considered. Postnatal evaluation is also important, because many newborns may be asymptomatic and clinical anomalies can be diagnosed when sequelae are permanent.

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“…Por sí sola, no se considera un hallazgo compatible con infección por CMVc, ya que está presente en el 0,4% al 5,8% de los RN de término sanos 96 y hasta en el 15% de las ecografías de los prematuros 145 . Tiene relación con fenómenos de hipoxia/isquemia expresada en un territorio vascular más vulnerable, y no se ha correlacionado con alteraciones en el neurodesarrollo en el seguimiento a 12 meses 117 .…”

Section: Ecografía Cerebralunclassified

“…La ecografía tiene limitaciones en la evaluación de la sustancia blanca y en la detección de anormalidades corticales y de la fosa posterior; esto ha llevado al uso de la RM en forma más precoz y sistemática 117,146 .…”

Section: Ecografía Cerebralunclassified

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Recomendaciones para el diagnóstico y el manejo de la infección por citomegalovirus en la mujer embarazada y el recién nacido

Izquierdo¹,

Sandoval²,

Abarzúa-Camus³

et al. 2024

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infección por citomegalovirus (CMV) en la mujer embarazada y el recién nacido. Esta guía aborda el manejo de la infección en el binomio, su enfrentamiento diagnóstico y terapéutico, orientado al equipo de salud que atiende a mujeres embarazadas y recién nacidos con infección por CMV en Chile. Considera la situación epidemiológica global y latinoamericana, con recomendaciones para la evaluación clínica y de laboratorio; establece criterios de diagnóstico, propone enfoques terapéuticos de acuerdo a la situación clínica, analiza las medidas de prevención y establece una propuesta nacional para el seguimiento de esta enfermedad. Se ha puesto especial énfasis en entregar, de forma práctica, y con la mayor evidencia posible, las recomendaciones para el manejo del binomio con infección por CMV.

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Role of Magnetic Resonance Imaging and Cranial Ultrasonography in Congenital Cytomegalovirus Infection

Cited by 17 publications

References 21 publications

Targeted screening for congenital cytomegalovirus infection: clinical, audiological and neuroimaging findings

Targeted screening for congenital cytomegalovirus infection: clinical, audiological and neuroimaging findings

An Overview of Cytomegalovirus Infection in Pregnancy

Recomendaciones para el diagnóstico y el manejo de la infección por citomegalovirus en la mujer embarazada y el recién nacido

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