pediatrics
Congenital and Perinatal Cytomegalovirus Infection (CMV)
Diagnosis of Congenital and Perinatal CMV Infection
Viral culture using urine, saliva, or tissue Polymerase chain reaction (PCR) testing using urine, saliva, blood, or tissue Symptomatic congenital CMV infection must be distinguished from other congenital infections, including Congenital Toxoplasmosis , In neonates, viral detection using culture or PCR of urine, saliva, or a tissue sample is the primary diagnostic tool; maternal diagnosis can also be made by serologic testing or PCR ( see Diagnosis ). Culture specimens should be refrigerated until inoculation of fibroblast cells. Congenital CMV is diagnosed if the virus is identified in urine, saliva, or other body fluids obtained within the first 2 to 3 weeks of life; urine and saliva have the highest sensitivity. After 3 weeks, viral detection may indicate perinatal or congenital infection. Infants may shed CMV for several years after either type of infection. A complete blood count (CBC) with differential and liver tests may be helpful but are not specific. Cranial ultrasonography or CT and an ophthalmologic evaluation should also be done. Periventricular calcifications are commonly found on CT. Hearing tests should be routinely done at birth in all infected neonates, and continued close monitoring is required because hearing loss may develop after the neonatal period and be progressive. 