[Congenital cytomegalovirus infection].
The cytomegalovirus (CMV) is responsible for the most common congenital infection and represents the most important cause of mental disability and non hereditary sensorineural deafness in infants. One percent to 5% of women show symptoms of infection during pregnancy. Forty thousand newborns are affected by this infection in the United States every year, at a cost of 1.9 billion dollars; in Italy, approximately 5,500 infected newborns are expected each year, including 350 in Lombardia alone. In 90% of the cases, the infected newborns present no symptoms at birth, but, in 10% to 15% of these cases, they are not immune to future manifestations of the infection. Ten percent of newborns with congenital infection, however, show symptoms that lead to a strongly unfavourable prognosis. The authors describe the most important pre and post natal diagnostic findings and emphasize the importance of counseling in this pathology. They also point out the least frequent clinical manifestations of the infection in newborns, which can cause problems of differential diagnosis. In light of the most recent literary data, the article outlines the most recent therapeutic schemes as well as their effectiveness. Lastly, the authors discuss the sequels of the congenital infection, which can present themselves in infected newborns even after a long period of time. This corresponds to one of the most important aspects of the topic and the authors propose a follow-up program that applies to those children until the age of 6. There is currently no effective or safe vaccine for the CMV, therefore hygienic-health measures constitute the principal form of prevention of the CMV congenital infection, which represents a significant problem for newborns, their families, and society.
Lombardi
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Neonatologia, Patologia Neonatale e Terapia Intensiva, IRCCS Policlinico San Matteo, Pavia.
Stronati
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D000998:Antiviral Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission*; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D015774:Ganciclovir / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D007223:Infant; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D011296:Prenatal Diagnosis; D013997:Time Factors
D000998:Antiviral Agents; D016756:Immunoglobulins, Intravenous; D015774:Ganciclovir