title: A neonate with reduced cytomegalovirus DNA copy number and marked improvement of hearing in the treatment of congenital cytomegalovirus infection.
abstract: Congenital cytomegalovirus (CMV) infection can cause severe permanent disabilities. A mother who is seronegative before conception but acquires infection during pregnancy is a risk factor for congenital infection. We describe a neonate in whom congenital CMV infection was diagnosed at birth and confirmed with DNA quantitation by means of the polymerase chain reaction, was accompanied by cerebral ventriculomegaly and severe hearing loss, and was treated with ganciclovir/valganciclovir for 6 weeks. Initially, cerebral ventriculomegaly and calcification were also found with computed tomography, and severe hearing loss was detected with auditory brainstem response testing. After treatment, CMV DNA decreased in copy number and became undetectable. No marked side effects occurred after treatment. Surprisingly, 1 year after treatment, neurological and motor development was equivalent to that in a healthy infant. Audiometry indicated that auditory ability would improve with rehabilitation, speech and language therapy, and cochlear implantation. Single-photon emission computed tomography showed marked improvement 6 months after treatment. This case provides compelling evidence that a reliable diagnosis of congenital CMV infections coupled with a prompt and appropriate treatment program can prevent permanent disability. It is, therefore, important to establish a more effective strategy for the management of congenital CMV infection.
authors.affiliation: Department of Pediatrics, Tama Nagayama Hospital, Nippon Medical School, Tokyo, Japan. shuros0905@gmail.com
authors.forename: Jun
authors.initials: J
authors.lastname: Hayakawa
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Kawakami
authors.forename: Sachiyo
authors.initials: S
authors.lastname: Takeda
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ozawa
authors.forename: Ryuji
authors.initials: R
authors.lastname: Fukazawa
authors.forename: Masato
authors.initials: M
authors.lastname: Takase
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Fukunaga
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use*; D001299:Audiometry; D003587:Cytomegalovirus / Q000187:drug effects* / Q000235:genetics; D003586:Cytomegalovirus Infections / Q000150:complications / Q000151:congenital / Q000188:drug therapy*; D004279:DNA, Viral / Q000235:genetics; D004359:Drug Therapy, Combination; D015774:Ganciclovir / Q000031:analogs & derivatives / Q000627:therapeutic use; D006319:Hearing Loss, Sensorineural / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D006849:Hydrocephalus / Q000188:drug therapy / Q000209:etiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D015899:Tomography, Emission-Computed, Single-Photon; D016896:Treatment Outcome; D000077562:Valganciclovir; D014779:Virus Replication / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D004279:DNA, Viral; D000077562:Valganciclovir; D015774:Ganciclovir