Postnatally acquired cytomegalovirus infections in infants of CMV-excreting mothers (original) (raw)

Congenital cytomegalovirus infection: recent advances in the diagnosis of maternal infection

Human Immunology, 2004

In most European countries, pregnant women are tested for cytomegalovirus (CMV) during the first trimester of pregnancy. Within the last 5 years, European laboratories have made significant progress in solving diagnostic problems linked to infection in pregnancy. With advances in CMV serology, the presence of anti-CMV immunoglobulin (Ig)M detected by a screening test such as enzyme immunoassay, can be confirmed by blot, identifying pregnant women undergoing an active or recent infection. Furthermore, primary infections that were proven if a seroconversion was observed or suspected in the presence of IgM, can now be readily diagnosed by disclosing the presence of anti-CMV low avidity in IgM-positive mothers, greatly reducing the number of women who should be considered at risk of transmitting the virus. Virologic maternal tests are not enough to diagnose a recent primary maternal CMV infection and the detection or quantification of CMV in maternal blood does not seem to be associated with a higher risk for fetal infection. A cohort of 1520 pregnant women considered at risk of transmitting the virus were followed in a longitudinal study at the University of Bologna. Women were identified as part of routine CMV screening in several Italian regions and were IgM-positive for CMV. We documented IgG seroconversion in 83 women and 1437 were IgM-positive by commercial kit. Human Immunology 65, 410Ϫ415 (2004).

A particular case of cytomegalovirus infection in infancy

Romanian journal of morphology and embryology = Revue roumaine de morphologie et embryologie, 2016

The clinical spectrum of perinatal infection varies from asymptomatic infection or mild disease to severe systemic involvement. The aim of this paper is to present a severe intrauterine infection, which led to difficulties in diagnosis and unfavorable evolution. CASE PRESENTATION M.E., 6-weeks-old, born small for gestational age, was admitted in our Hospital for gastrointestinal signs: diarrhea, abdominal distension, observed three days earlier. Clinical and biological exams revealed hepatic disease related with hepatic cytolysis and cholestasis. Abdominal ultrasound showed large amounts of ascitic fluid, cirrhotic liver, enlarged portal vessel with hepatopetal flow, normal gallbladder and biliary tract. Computed tomography (CT) angiography revealed a wide hepatic artery, the presence of portal vein and absence of splenic vein. Serology detected IgM anti-cytomegalovirus antibodies. Postmortem histological exam confirmed the liver cirrhosis; cell free cytomegalovirus (CMV) antigens w...

Cytomegalovirus infections during pregnancy

Current Opinion in Obstetrics and Gynecology, 2011

Purpose of review To review current prenatal diagnosis and management of congenital cytomegalovirus (CMV) infections with emphasis on maternal screening and available interventions. Recent findings Recent findings include an enhanced understanding of the epidemiology, pathogenesis, and treatment of CMV infections; a knowledge of high-risk women particularly those with chronic exposure to a young child in the home; the availability of accurate methods for the serologic diagnosis of a primary CMV infection using either single or serial blood samples; accurate methods for the diagnosis of fetal infection via amniotic fluid; sensitive fetal and placental indicators for neonatal outcomes, and the availability of potentially effective interventions such as hygienic intervention and CMV hyperimmune globulin. Summary These findings suggest that serologic testing for CMV during pregnancy may be appropriate either using one-time testing or serial serologic testing throughout the first two trimesters of pregnancy and that education of pregnant women about CMV is necessary so that they can asses their risk and make informed choices about serologic screening.

Cytomegalovirus Infection in Pregnancy: Prevention, Presentation, Management and Neonatal Outcomes

Journal of Midwifery & Women's Health, 2021

Congenital cytomegalovirus (cCMV) is the most common congenital infection in the United States, with 1 of 200 live births affected. It is the leading viral cause of intrauterine fetal demise and miscarriage. It is a common cause of neonatal hearing loss, second only to genetic factors. Yet, health care provider awareness remains low. The purpose of this article is to provide a brief overview of the epidemiology, presentation, diagnosis, and treatment of antenatal cytomegalovirus (CMV) infection and cCMV in the neonate. Maternal CMV infection in pregnancy often presents with mild cold‐like symptoms or is asymptomatic. The virus can be vertically transmitted to a growing fetus, the risk of transmission and severity of fetal impact varying by timing of exposure during pregnancy. Most neonates born with cCMV show no signs at birth, yet 15% to 25% will have long‐term adverse neurodevelopmental conditions. Misconceptions that cCMV cannot be prevented or that neonates born without signs of...

Prenatal diagnosis of congenital cytomegalovirus infection: Two decades later

American Journal of Obstetrics and Gynecology, 1990

Cytomegalovirus is the most common cause of congenital infection in the United States, yet there has been little progress in the prenatal diagnosis of this intrauterine infection. We present evidence that viral culture of amniotic fluid may be a useful adjunct procedure, when performed as part of the antenatal evaluation of suspected fetal cytomegalovirus infection. (AM J OBSTET GVNECOL 1990;163:447-50.) Cytomegalovirus (CMV) is the most common cause of congenital infection, affecting 30,000 to 40,000 liveborn infants annually in the United States.1.2 However, prenatal diagnosis of fetal CMV infection has received little attention over the last 20 years and was not mentioned in a recent editorial strongly urging renewed efforts to eliminate the problem.' In this Clinical Opinion, we briefly survey the epidemiologic characteristics of congenital CMV infection. Then we review published methods of prenatal diagnosis and provide evidence for our opinion that viral cultures of amniotic fluid may be a useful procedure. Finally, we suggest that antenatal diagnosis can play an important role in suggested programs that seek to prevent congenital infection and to treat those cases that do occur.

Prenatal indicators of congenital cytomegalovirus infection

The Journal of Pediatrics, 2000

Objective: To assess the validity of a diagnostic protocol designed to predict the outcome of newborns of mothers suspected to have primary cytomegalovirus (CMV) infection during the first 4 months of pregnancy.

Prevalence of Cytomegalovirus Infection in Hospitalized Infants

Folia Medica, 2012

Data on cytomegalovirus infection (CMV) prevalence and course in hospitalized infants are rather scarce, obsolete and considerably inconsistent. AIM: to determine the prevalence, rate of clinical manifestations, risk factors and predictive capacity of clinical manifestations of CMV infection in hospitalized infants during their fi rst year of life. PATIENTS AND METHODS: All 163 infants hospitalized in the Pediatric Ward for Nonrespiratory Pathology in a tertiary hospital were serologically screened for cytomegalovirus infection for 10 months. In infants up to 6 months old that were CMV IgG (+) and CMV IgM (-) we followed up the CMV IgG concentration or compared it with that of their mothers. RESULTS: The CMV prevalence for the entire study sample was 33.1 ± 3.7% (54 seropositive out of 163 examined infants); in newborns it was 19.4 ± 6.7% (7 of 36), in infants aged 1-3 months-23.8 ± 5.4% (15 of 63), in 4-6-month olds-28.1 ± 8.1% (9 of 32), and in 7-12-month old-71.9 ± 8.1% (23 of 32). The rates of clinically apparent infections in the respective groups was 33.3 ± 6.5%, 57.01 ± 20.2%, 53.3 ± 13.3%, 33.3 ± 16.6%, and 13.0 ± 7.17%. The overall rate of clinically apparent CMV infection in all 163 children was between 11.0 ± 2.5% and 17.2 ± 2.9%. The probability of CMV infection increased with age and duration of breastfeeding. Hepatitis, cerebral vasculopathy and pneumonia (alone or combined) turned out to be predictors of CMV infection, but none of these symptoms had a frequency greater than 22%. CONCLUSIONS: We found a high rate of cytomegalovirus infections in hospitalized infants less than one year of age. This infection is the reason why at least 10% of the newborns and 12% of the children aged 1 to 3 months were hospitalised. The course was clinically apparent in over half of the infected children of up to 3 months of age.

Diagnostic problems of cytomegalovirus infections in premature newborns

Polish annals of medicine, 2010

Introduction. Cytomegaly is an infectious, widespread viral disease. It is caused by Cytomegalovirus (CMV), which belongs to the DNA viruses group from the Herpesviridae family. The virus is human specific. Once infected, a person remains seropositive to the end of life and the virus remains latent particularly in leukocytes, which are its main reservoir. Many different disease manifestations, which depend partially on a patient's age, but mostly on an immunological state, may be caused by CMV. Aim. The aim of this work was the assessment and histoclinical analysis of CMV infection in a male newborn with a congenital anomaly syndrome. Case study and examination results. A male newborn, born in the 30 th week of gestation, diagnosed with congenital anomaly syndrome, Apgar score was 2. In the neonatal period hypertrophic cardiomyopathy involving the right ventricle, esophageal atresion, esophagotracheal fistula, hepatosplenomegaly, respiratory insufficiency and hyperechogenic periventricular structures in the brain were diagnosed. During the entire hospitalization period a progression of inflammatory changes in the lungs was observed. The results of serological tests to detect anti-CMV and toxoplasmosis specific antibodies were: CMV-IgG 21.00 IU/mL; CMV-IgM negative; Toxo-IgG 4.0 IU/mL; Toxo-IgM negative. Restoration of esophageal continuity and repair of the fistula were performed surgically. Follow-up serological test was positive for anti-CMV antibodies in the IgG and IgM classes. The patient died on the 79 th day following hospital admission. Autopsy and histopathological tests confirmed generalized cytomegalovirus infection.