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Congenital cytomegalovirus

CMV - congenital; Congenital CMV; Cytomegalovirus - congenital

 

Congenital cytomegalovirus is a condition that can occur when an infant is infected with a virus called cytomegalovirus (CMV) before birth. Congenital means the condition is present at birth.

Causes

 

Congenital cytomegalovirus occurs when an infected mother passes CMV to the fetus through the placenta. The mother may not have symptoms, so she may be unaware that she has CMV.

 

Symptoms

 

Most children infected with CMV at birth do not have symptoms. Those who do have symptoms may have:

  • Inflammation of the retina
  • Yellow skin and whites of the eyes (jaundice)
  • Large spleen and liver
  • Low birth weight
  • Mineral deposits in the brain
  • Rash at birth
  • Seizures
  • Small head size

 

Exams and Tests

 

During the exam, the health care provider may find:

  • Abnormal breath sounds indicating pneumonia
  • Enlarged liver
  • Enlarged spleen
  • Delayed physical movements (psychomotor retardation)

Tests include:

  • Antibody titer against CMV for both the mother and infant
  • Bilirubin level and blood tests for liver function
  • CBC
  • CT scan or ultrasound of the head
  • Fundoscopy
  • TORCH screen
  • Urine culture for CMV virus in the first 2 to 3 weeks of life
  • X-ray of the chest

 

Treatment

 

There is no specific treatment for congenital CMV. Treatments focus on specific problems, such as physical therapy and appropriate education for children with delayed physical movements.

Treatment with antiviral medicines is often used for infants with neurologic (nervous system) symptoms. This treatment may reduce hearing loss later in the child's life.

 

Outlook (Prognosis)

 

Most infants who have symptoms of their infection at birth will have neurologic abnormalities later in life. Most infants without symptoms at birth will NOT have these problems.

Some children may die while they are still an infant.

 

Possible Complications

 

  • Difficulty with physical activities and movement
  • Vision problems or blindness
  • Deafness

 

When to Contact a Medical Professional

 

Have your baby checked right away if a provider did not examine your baby shortly after birth, and you suspect your baby has:

  • A small head
  • Other symptoms of congenital CMV

If your baby has congenital CMV, it is important to follow your provider's recommendations for well-baby examinations. That way, any growth and development problems can be identified early and treated promptly.

 

Prevention

 

Cytomegalovirus is almost everywhere in the environment. The U.S. Centers for Disease Control and Prevention (CDC) recommend the following steps to reduce the spread of CMV:

  • Wash hands with soap and water after touching diapers or saliva.
  • Avoid kissing children under the age of 6 on the mouth or cheek.
  • Do not share food, drinks, or eating utensils with young children.
  • Pregnant women working in a day care center should work with children older than age 2½.

 

 

References

Crumpacker CS II. Cytomegalovirus (CMV). In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 8th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2014:chap 140.

Swanson EC. Congenital cytomegalovirus infection: new prospects for prevention and therapy. Pediatr Clin North Am. 2013 April 1; 60(2):335-349.

 
  • Congenital cytomagalovirus

    Congenital cytomagalovirus - illustration

    Congenital cytomegalovirus is caused when an infected mother passes the virus to the fetus through the placenta. The infant is characteristically born with a rash, a large spleen or liver, jaundice, inflammation of the retina, and a small head.

    Congenital cytomagalovirus

    illustration

  • Antibodies

    Antibodies - illustration

    Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.

    Antibodies

    illustration

    • Congenital cytomagalovirus

      Congenital cytomagalovirus - illustration

      Congenital cytomegalovirus is caused when an infected mother passes the virus to the fetus through the placenta. The infant is characteristically born with a rash, a large spleen or liver, jaundice, inflammation of the retina, and a small head.

      Congenital cytomagalovirus

      illustration

    • Antibodies

      Antibodies - illustration

      Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.

      Antibodies

      illustration

    A Closer Look

     

    Tests for Congenital cytomegalovirus

     

       

      Review Date: 4/21/2015

      Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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