title: [Cytomegalovirus infection: congenital or postnatally acquired? Importance of the Guthrie card].
abstract: A girl aged 4 weeks had persistent pulmonary hypertension of the newborn, haematological abnormalities and hepatosplenomegalia due to a cytomegalovirus (CMV) infection; thereafter she had a psychomotoric retardation. A girl aged 6 months had psychomotoric retardation and microcephaly due to a CMV infection, with epilepsy and perception deafness. A polymerase chain reaction (PCR) for CMV-DNA in the blood on the Guthrie card demonstrated retrospectively in both cases that the infection was congenital. A 4-month-old boy had parents who had both experienced a CMV infection around the birth of the child. The child was infected with CMV but the absence of CMV-DNA in the blood on the Guthrie card revealed that the infection was not congenital. Only 10% of infants with congenital CMV infection are symptomatic at birth; the prognosis is then poor. Up to 10-15% of the asymptomatic patients will develop neurological manifestations. For the diagnosis of congenital CMV infection virus isolation is required within 3 weeks after birth. However, when CMV infection is not considered during this period it is later still possible to diagnose congenital CMV infection with a PCR for CMV-DNA in blood spots of Guthrie cards taken during the first week of life.
authors.affiliation: Spaarne Ziekenhuis, afd. Kindergeneeskunde, Postbus 1644, 2003 BR Haarlem.
authors.forename: H H
authors.initials: HH
authors.lastname: Kiezebrink-Lindenhovius
authors.forename: Y L
authors.initials: YL
authors.lastname: van den Berg
authors.forename: A B
authors.initials: AB
authors.lastname: Sprikkelman
authors.forename: J F
authors.initials: JF
authors.lastname: Weel
authors.forename: R H
authors.initials: RH
authors.lastname: Veenhoven
mesh_terms: D003587:Cytomegalovirus / Q000235:genetics / Q000302:isolation & purification*; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000175:diagnosis / Q000635:transmission*; D004279:DNA, Viral / Q000097:blood; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016133:Polymerase Chain Reaction; D013997:Time Factors
chemical_list: D004279:DNA, Viral