Severe neonatal cytomegalovirus infection: about a case

Pan Afr Med J. 2017 Jun 30:27:161. doi: 10.11604/pamj.2017.27.161.12004. eCollection 2017.

Abstract

Maternofoetal infection with Cytomegalovirus (CMV) is the most common congenital infection and a leading cause of mental retardation and sensori-neural hearing loss. Population-based studies indicate that at least 0.5% of all infants born alive have CMV of whom approximately 10% have clinically evident symptomsat birth. The Justification of systematic screening for foetal CMV infection is still controversial and is not recommended in most developed countries. This is mainly justified by the paucity of antenatal prognostic factors and the lack of established intrauterine treatment when foetal infection has been diagnosed. In case of congenital CMV infection, infants can be symptomatic or asymptomatic at birth. Mortality for such infants can reach 30%, and survivors can have mental retardation, sensorineural hearing loss, chorioretinitis, and other significant medical problems. A newborn symptomatic is defined by the existence of clinical and / or biological signs and / or neonatal imaging, the most frequent clinical signs are: hepatosplenomegaly (60%), microcephaly (53%), jaundice (67%), petechiae (76%), at least one neurological abnormality (68%). The frequency of biological abnormalities is as follows: increase in transaminases (83%), thrombocytopenia (77%), hyperbilirubinemia (69%), haemolysis (51%), hyperproteinorrachy (46%). The abnormalities of neonatal imaging are present in 70% of symptomatic newborns; intracerebral calcifications are the most frequent abnormalities. We report a case of newborn who presented a congenital infection by CMV, evoked on the intrauterine growth retardation, organs of the reticulo endothelial and haematological system were reached while nervous system was spared, and CMV PCR was very positive. indicating an antiviral treatment for 6weeks based on ganciclovir.

Keywords: Cytomegalovirus; congenital infection; ganciclovir; intrauterine growth retardation; petechiae.

Publication types

  • Case Reports

MeSH terms

  • Antiviral Agents / therapeutic use*
  • Cytomegalovirus Infections / congenital*
  • Cytomegalovirus Infections / drug therapy
  • Cytomegalovirus Infections / physiopathology
  • Female
  • Fetal Growth Retardation / virology*
  • Ganciclovir / therapeutic use*
  • Humans
  • Infant, Newborn
  • Infectious Disease Transmission, Vertical
  • Male
  • Pregnancy
  • Pregnancy Complications, Infectious / virology
  • Severity of Illness Index

Substances

  • Antiviral Agents
  • Ganciclovir