Evaluation of clinically asymptomatic high risk infants with congenital cytomegalovirus infection

• Published in: Journal of perinatology Vol. 40; no. 1; pp. 89 - 96
• Main Authors: Ronchi, Andrea, Zeray, Fiker, Lee, Lizette E., Owen, Kris E., Shoup, Angela G., Garcia, Fabiana, Vazquez, Liliana N., Cantey, Joseph B., Varghese, Shawn, Pugni, Lorenza, Mosca, Fabio, Sánchez, Pablo J.
• Format: Journal Article
• Language: English
• Published: New York Nature Publishing Group US 01-01-2020; Nature Publishing Group
• Subjects: 692/1807; 692/308; Alanine Transaminase - blood; Anemia; Antiviral agents; Antiviral Agents - therapeutic use; Bilirubin; Blood; Blood Cell Count; Brain - diagnostic imaging; Brain - pathology; Cytomegalovirus; Cytomegalovirus infections; Cytomegalovirus Infections - complications; Cytomegalovirus Infections - congenital; Cytomegalovirus Infections - drug therapy; Eye; Eye examinations; Female; Ganciclovir - therapeutic use; Genetic disorders; Gestational Age; Health risks; Hearing loss; Hearing Loss, Sensorineural - diagnosis; Hearing Loss, Sensorineural - etiology; Hemorrhage; Humans; Infant, Newborn; Infants; Infants (Newborn); Infection; Male; Medical examination; Medical imaging; Medicine; Medicine & Public Health; Mothers; Neonatology; Neuroimaging; Newborn babies; NMR; Nuclear magnetic resonance; Pediatric Surgery; Pediatrics; Physical Examination; Pregnancy; Retrospective Studies; Statistical analysis; Thrombocytopenia - diagnosis; Thrombocytopenia - etiology; Ultrasonic imaging; Ultrasound imaging; Valganciclovir - therapeutic use; Viral infections; Argentina; Texas
• ISSN: 0743-8346; 1476-5543
• DOI: 10.1038/s41372-019-0501-z

Objective
To determine the frequency of abnormal findings on evaluation of neonates with congenital CMV infection who have a normal physical examination
Study design
Retrospective, 2-center study (1996–2017) that reviewed results of complete blood cell count and platelets, serum alanine aminotransferase (ALT) and bilirubin concentrations, eye examination, cranial ultrasonography or other neuroimaging, and brainstem evoked responses performed on neonates with congenital CMV infection and a normal physical examination
Results
Of 34 infants with congenital CMV infection and a normal physical examination, 56% (19/34) had ≥1 abnormality: 39%, elevated ALT concentration; 45%, abnormal neuroimaging (five, lenticulostriate vasculopathy; six, intraventricular hemorrhage; four, calcifications); 12%, anemia; 16%, thrombocytopenia; and 3%, chorioretinitis. Seven (21%) infants had sensorineural hearing loss, and 18 infants received antiviral therapy.
Conclusion
Some infants with congenital CMV infection and a normal physical examination had abnormalities on laboratory or neuroimaging evaluation, which in some cases prompted antiviral treatment.