Variable outcome of a congenital cytomegalovirus infection in a quadruplet after primary infection of the mother during pregnancy

Pm, Schneeberger; Groenendaal, Floris; Vries, LS de; Loon, AM van; Vroom, TM

doi:10.1111/j.1651-2227.1994.tb13189.x

Cited by 25 publications

(16 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Seven of 8 symptomatic infants had severe cerebral abnormalities on cUS and MRI; 5 infants (63%) died; 2 (25%) had a poor neurodevelopmental outcome with cerebral palsy, cognitive impairment, epilepsy and bilateral SNHL for which they use hearing aids; 1 (12%) with mild cUS abnormalities did not show additional MRI lesions and had a normal neurodevelopmental outcome at the age of 1.4 years. The 2 asymptomatic infants were part of a quadruplet with variable expression of a first trimester congenital CMV infection as reported previously [18]. These infants had no or mild abnormalities on cUS and developed no sequelae and bilateral SNHL with mild cognitive delay, respectively, during the follow-up.…”

Section: Resultsmentioning

confidence: 99%

Neuro-Imaging Findings in Infants with Congenital Cytomegalovirus Infection: Relation to Trimester of Infection

et al. 2015

View full text Add to dashboard Cite

Background: Congenital cytomegalovirus (cCMV) infection early in pregnancy may result in major disabilities. Cerebral abnormalities detected using cranial ultrasound (cUS) and magnetic resonance imaging (MRI) have been related to neurological sequelae. Objective: To evaluate the additional value of MRI and assess the relationship between time of infection during pregnancy and outcome in infants with cCMV infection. Methods and Study Design: Demographic and clinical data were collected in infants with cCMV infection (1992-2013). Trimester of infection, neuro-imaging results and outcome were reviewed. Cerebral abnormalities were categorized into none, mild (lenticulostriate vasculopathy, germinolytic cysts, high signal intensity on T2-weighted images) and severe (migrational disorder, ventriculomegaly, cerebellar hypoplasia). Results were statistically analysed. Results: Thirty-six infants were eligible for analysis. cUS was performed in all and cranial MRI in 20 infants. Migrational disorders were only diagnosed using MRI (p < 0.01). In 17 infants trimester of infection was ascertained. Seven out of 10 infants infected during the first trimester had severe abnormalities on cUS (5 confirmed on MRI) and adverse sequelae; 3 had no/mild abnormalities on cUS/MRI and normal outcome. Two out of 3 infants infected during the second trimester with no/mild abnormalities on cUS/MRI had normal outcome; 1 with mild cUS and MRI abnormalities developed sensorineural hearing loss. Four infants infected during the third trimester with no/mild abnormalities on cUS/MRI had normal outcome. Conclusion: Infants with a first trimester cCMV infection are most at risk of severe cerebral abnormalities and neurological sequelae. MRI, and not cUS, enables an early diagnosis of migrational disorders, which can improve prediction of outcome.

show abstract

Section: Resultsmentioning

confidence: 99%

Neuro-Imaging Findings in Infants with Congenital Cytomegalovirus Infection: Relation to Trimester of Infection

et al. 2015

View full text Add to dashboard Cite

show abstract

“…In particular, in one set of congenitally infected twins who appeared asymptomatic at birth, one member was normal at follow-up, while the other had bilateral deafness, was restless, and had poor attention (231). More recently, the variable outcome of three infected survivors of a quadruplet pregnancy has been reported (236). One infant had cholestatic jaundice at birth and died of liver failure at 3 months of age, one infant showed no signs or symptoms at 18 months of age, and the remaining infant had hearing loss and delayed development.…”

Section: Congenital Infection In Twinsmentioning

confidence: 98%

“…Histopathological examination of the placentas showed inflammatory signs in cases of fetal infection, whereas they were apparently normal in noninfected siblings (3). In the case of congenital infection in a quadruplet pregnancy, HCMV immediate-early antigens were detected in three available placentas in the absence of viral inclusions (236).…”

Section: Congenital Infection In Twinsmentioning

confidence: 99%

Diagnosis and Management of Human Cytomegalovirus Infection in the Mother, Fetus, and Newborn Infant

2002

View full text Add to dashboard Cite

Human cytomegalovirus (HCMV) is the leading cause of congenital viral infection and mental retardation. HCMV infection, while causing asymptomatic infections in most immunocompetent subjects, can be transmitted during pregnancy from the mother with primary (and also recurrent) infection to the fetus. Hence, careful diagnosis of primary infection is required in the pregnant woman based on the most sensitive serologic assays (immunoglobulin M [IgM] and IgG avidity assays) and conventional virologic and molecular procedures for virus detection in blood. Maternal prognostic markers of fetal infection are still under investigation. If primary infection is diagnosed in a timely manner, prenatal diagnosis can be offered, including the search for virus and virus components in fetal blood and amniotic fluid, with fetal prognostic markers of HCMV disease still to be defined. However, the final step for definite diagnosis of congenital HCMV infection is detection of virus in the blood or urine in the first 1 to 2 weeks of life. To date, treatment of congenital infection with antiviral drugs is only palliative both prior to and after birth, whereas the only efficacious preventive measure seems to be the development of a safe and immunogenic vaccine, including recombinant, subunit, DNA, and peptide-based vaccines now under investigation. The following controversial issues are discussed in the light of the most recent advances in the field: the actual perception of the problem; universal serologic screening before pregnancy; the impact of correct counseling on decision making by the couple involved; the role of prenatal diagnosis in ascertaining transmission of virus to the fetus; the impact of preconceptional and periconceptional infections on the prevalence of congenital infection; and the prevalence of congenitally infected babies born to mothers who were immune prior to pregnancy compared to the number born to mothers undergoing primary infection during pregnancy

show abstract

“…Clinical manifestations are severer in the offspring of mothers who became infected early in pregnancy [3, 8]. The maternal primary infection causes more problems to the infected offspring than maternal reactivation disease [3, 9, 10]. Clinical manifestations are seen in less than 10% of affected newborns and …”

Section: General Considerationsmentioning

confidence: 99%

Cytomegalovirus Infection in Normal and Immunocompromised Humans

et al. 2000

View full text Add to dashboard Cite

Although cytomegalovirus (CMV) disease is a severe complication among immunocompromised patients, its cutaneous features have not been reported frequently. CMV belongs to the Herpesviridae family sharing with the other members the ability to remain latent in their natural hosts after an initial infection and to produce overt disease in several settings. The natural history of human CMV infection is characterized by primary infection, latent infection and reinfection. This article reviews the extremely variable aspects of the clinical presentation of CMV infection in normal and immunocompromised humans, focusing on the dermatological manifestations, and indicates the laboratory tests for detecting CMV responsibility in skin disorders.

show abstract

Variable outcome of a congenital cytomegalovirus infection in a quadruplet after primary infection of the mother during pregnancy

Cited by 25 publications

References 16 publications

Neuro-Imaging Findings in Infants with Congenital Cytomegalovirus Infection: Relation to Trimester of Infection

Neuro-Imaging Findings in Infants with Congenital Cytomegalovirus Infection: Relation to Trimester of Infection

Diagnosis and Management of Human Cytomegalovirus Infection in the Mother, Fetus, and Newborn Infant

Cytomegalovirus Infection in Normal and Immunocompromised Humans

Contact Info

Product

Resources

About