title: [Congenital cytomegaly in one twin - a case report].
abstract: A report on dichorionic/diamniotic pregnancy in which only one, female, fetus was infected with cytomegalovirus and presented with severe congenital diseases at birth. Infection of the fetus occurred after recurrent maternal infection. The second, male, fetus did not have CMV infection. The cesarean section was performed at the 38th week of gestation. The birth weight of the infected girl was 1680g, the main symptoms, beside dystrophy, concerned the central nervous system: microcephaly, brain atrophy, hydrocephalus, corpus callosum agenesis. She also had Turner syndrome symptoms. The viral load was highest in the urine 81.2 x10^6/ml, in the cerebro-spinal fluid 15.4x10^6/ml and lower in blood 0.38 x10^5/ml. The concentration of specific IgG was 308 U/ml. Specific IgM was not detected. Throughout hospitalization, the infection maintained only one viral genotype gB2. Despite treatment with ganciclovir (10 weeks) and foscarnet (2 weeks), the girl died at the age of 8 months. Novel molecular diagnostic techniques (nested and real time PCR) confirmed the congenital infection and were helpful in the monitoring of the infection and treatment efficacy.
authors: Klinika Chorób Dzieci Katedry Pediatrii, Uniwersytet Jagielloński, Collegium Medium w Krakowie, ul. Wielicka 265, 30-663 Kraków. ttomasik1@cm-uj.krakow.pl
authors: Tomasz
authors: T
authors: Tomasik
authors: Barbara
authors: B
authors: Zawilińska
authors: Dorota
authors: D
authors: Pawlik
authors: Justyna
authors: J
authors: Ferek
authors: Justyna
authors: J
authors: Ferek
authors: Anna
authors: A
authors: Wójtowicz
authors: Magda
authors: M
authors: Rybak-Krzyszkowska
authors: Ryszard
authors: R
authors: Lauterbach
authors: Jacek J
authors: JJ
authors: Pietrzyk
mesh_terms: D000015:Abnormalities, Multiple / Q000175:diagnosis / Q000821:virology*; D000328:Adult; D061085:Agenesis of Corpus Callosum / Q000821:virology; D000998:Antiviral Agents / Q000627:therapeutic use; D002555:Cerebrospinal Fluid / Q000821:virology; D003586:Cytomegalovirus Infections / Q000151:congenital* / Q000175:diagnosis / Q000188:drug therapy / Q000635:transmission*; D004200:Diseases in Twins / Q000151:congenital* / Q000175:diagnosis / Q000188:drug therapy / Q000821:virology; D017809:Fatal Outcome; D005260:Female; D017245:Foscarnet / Q000627:therapeutic use; D015774:Ganciclovir / Q000627:therapeutic use; D006801:Humans; D006849:Hydrocephalus / Q000821:virology; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D008831:Microcephaly / Q000821:virology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000175:diagnosis; D011297:Prenatal Exposure Delayed Effects; D014424:Turner Syndrome / Q000821:virology; D014556:Urine / Q000821:virology
chemical_list: D000998:Antiviral Agents; D017245:Foscarnet; D015774:Ganciclovir