pediatrics
Congenital and Perinatal Cytomegalovirus Infection (CMV)
Introduction
Cytomegalovirus infection may be acquired prenatally or perinatally and is the most common congenital viral infection. Signs at birth, if present, are intrauterine growth restriction, prematurity, microcephaly, jaundice, petechiae, hepatosplenomegaly, periventricular calcifications, chorioretinitis, pneumonitis, hepatitis, and sensorineural hearing loss. If acquired later in infancy, signs may include pneumonia, hepatosplenomegaly, hepatitis, thrombocytopenia, sepsis-like syndrome, and atypical lymphocytosis. Diagnosis of neonatal infection is best made by viral detection via culture or polymerase chain reaction testing. Treatment is mainly supportive. Parenteralgancicloviror oralvalganciclovirmay prevent hearing deterioration and improve developmental outcomes and is given to infants with symptomatic disease identified in the neonatal period. ( See also Cytomegalovirus (CMV) Infection in adults and Cytomegalovirus (CMV) is frequently isolated from neonates. Although most infants shedding this virus are asymptomatic, others have life-threatening illness and devastating long-term sequelae. It is not known when a woman with primary CMV can safely conceive. Because risk to the fetus is difficult to assess, women who develop primary CMV during pregnancy should be counseled, but few experts recommend routine serologic testing for CMV before or during pregnancy in healthy women. 