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Congenital Cytomegalovirus (CMV) Infection

Year 2016, Volume: 8 Issue: 6, 5 - 9, 08.11.2016

Abstract

Abstract

Cytomegalovirus is (CMV) the most common congenital infection causing significant morbidity and mortality in infants. It is the leading infectious cause severe long-term sequelae, including progressive sensorineural hearing loss and neurodevelopmental disability in the both developed and developing countries. This articlereviews the epidemiology, clinical features, diagnosis, treatment and prognosis forcytomegalovirus infections in the light of current literature. Approximately 10% ofinfants born with congenital CMV infection are symptomatic, resulting in clinical manifestations, including jaundice, hepatosplenomegaly, petechiae, microcephaly andintrauterine growth restriction. Diagnosis of congenital CMV infection at birth or inthe first 3 weeks of an infant's life is crucial, as this should prompt interventions forprevention of delayed-onset hearing loss and neurodevelopmental delay in affectedinfants. The safety of antiviral treatment of congenital CMV has been studied in wellcontrolled trials and the antiviral therapy of newborns has shown efficacy in reducing the more severe outcomes. In light of this information, Infants with congenital CMV infection, once identified, could then be considered as candidates for antiviral therapy, and in long term, neurodevelopmental and hearing screening follow-up plan should be established forinfants.

References

  • Kaynaklar 1.McGavran MH, Smith MG. Ultrastructural, cytochemical, andmicrochemical observations on cytomegalovirus (salivary glandvirus) infection of human cells in tissue culture. Exp Mol Pat-hol 1965; 76: 1-10. 2.Mandell GL, Bennett JE, Dolin R. Principles and practice ofinfectious diseases. 8th ed. Philadelphia: Churchill Livings-tone, 2015: 1738-53. 3.Britt W. Cytomegalovirus. In: Remington JS, Klein JO, WilsonCB, Baker CJ (eds). Infectious Diseases of the Fetus and New-born Infant, 7th ed. Elsevier Saunders: Philadelphia, 2011: 706. 4.Harrison GJ. Cytomegalovirus. In: Cherry JD, Harrison GJ,Kaplan SL, et al (eds). Feigin and Cherry’s Textbook of Pe-diatric Infectious Diseases, 7th ed. Elsevier Saunders: Phila-delphia, 2014: 1969. 5.Mocarski ES, Jr. Immunomodulation by Cytomegaloviruses:manipulative strategies beyond evasion. Trends Microbiol2002; 10: 332-39. 6.Hizel S, Parker S, Onde U. Seroprevalence of cytomegalovi-rus infection among children and females in Ankara, Turkey,1995. Pediatr Int 1999; 41: 506-509. 7.Kenneson A, Cannon MJ. Review and meta-analysis of the epi-demiology of congenital cytomegalovirus (CMV) infection. RevMed Virol 2007; 17: 253-76. 8.Cannon MJ. Congenital cytomegalovirus (CMV) epidemiologyand awareness. J Clin Virol 2009; 46 Suppl 4: S6-10. 9.American Academy of Pediatrics. Cytomegalovirus infection.In: Kimberlin DW (ed). Red Book: 2015 Report of the Com-mittee on Infectious Diseases, 30th, American Academy of Pe-diatrics: Elk Grove Village, IL, 2015: 317. 10.Boppana SB, Ross SA, Fowler KB Congenital cytomegalovirus infec-tion: clinical outcome. Clin Infect Dis 2013; 57 (Suppl 4): S178-81. 11.Boppana SB, Fowler KB, Vaid Y, et al. Neuroradiographic fin-dings in the newborn period and long-term outcome inchildren with symptomatic congenital cytomegalovirus infection. Pediatrics 1997; 99: 409-14. 12.Fowler KB, McCollister FP, Dahle AJ, Boppana S, Britt WJ,Pass RF. Progressive and fluctuating sensorineural hearingloss in children with asymptomatic congenital cytomegalovi-rus infection. J Pediatr 1997; 130: 624-30. 13.Fowler KB, Boppana SB. Congenital cytomegalovirus (CMV)infection and hearing deficit. J Clin Virol 2006; 35: 226-31. 14.Goderis J, De Leenheer E, Smets K, Van Hoecke H, Keymeu-len A, Dhooge I. Hearing loss and congenital CMV infection:a systematic review. Pediatrics 2014; 13: 972-82. 15.Grosse SD, Ross DS, Dollard SC. Congenital cytomegalovirus(CMV) infection as a cause of permanent bilateral hearing loss:a quantitative assessment. J Clin Virol 2008; 41: 57-62. 16.Michaels MG, Greenberg DP, Sabo DL, Wald ER. Treatmentof children with congenital cytomegalovirus infection with gan-ciclovir. Pediatr Infect Dis J 2003; 22: 504-509. 17.Oliver SE, Cloud GA, Sánchez PJ, et al. Neurodevelopmen-tal outcomes following ganciclovir therapy in symptomatic con-genital cytomegalovirus infections involving the central ner-vous system. J Clin Virol 2009; 46 (Suppl 4): S22-26. 18.Townsend CL, Forsgren M, Ahlfors K, Ivarsson SA, TookeyPA, Peckham CS. Long-term outcomes of congenital cytome-galovirus infection in Sweden and the United Kingdom. ClinInfect Dis 2013; 56: 1232-39.

Konjenital Sitomegalovirus (CMV) Enfeksiyonu

Year 2016, Volume: 8 Issue: 6, 5 - 9, 08.11.2016

Abstract

Öz

Sitomegalovirus (CMV), en sık görülen önemli morbidite ve mortaliteye neden olan konjenital enfeksiyondur. Hem gelişmiş hem de gelişmekte olan ülkelerde ilerleyici işitme kaybı ve nörogelişimsel geriliği gibi uzun dönem sekellerin önde gelen sebebidir. Bu çalışmada, güncel literatürlerle birlikte sitomegalovirus enfeksiyonlarının epidemiyolojisi, klinik özellikleri, tanı, tedavi ve prognozu gözden geçirilmektedir. Konjenital CMV enfeksiyonu olan bebeklerin yaklaşık %10’u semptomatiktir. Sarılık, hepatosplenomegali, peteşi, mikrosefali ve intrauterin gelişme geriliği gibi klinik bulgular ortaya çıkabilmektedir. Konjenital CMV enfeksiyonu olan bebeklerin doğumda ya da bir bebeğin hayatının ilk 3 hafta içinde tanı alması ilerleyici işitme kaybı ve nörogelişimsel gecikmenin önlenebilmesi için çok önemlidir. Antiviral ilaçlarla konjenital CMV enfeksiyonunun tedavisinin güvenilirliği yenidoğanlarda kontrollü çalışmalarla incelenmiş ve antiviral tedavinin ağır klinik sonuçları azaltmada etkin olduğu gösterilmiştir. Bu bilgiler ışığında konjenital CMV enfeksiyonuolan bebekler öncelikle tespit edilmeli ardından bu bebeklerin antiviral tedavi içinuygun aday olup olmadıkları kararlaştırılmalı ve nörogelişimsel ve işitme tarama takip bakım planları oluşturulmalıdır.

References

  • Kaynaklar 1.McGavran MH, Smith MG. Ultrastructural, cytochemical, andmicrochemical observations on cytomegalovirus (salivary glandvirus) infection of human cells in tissue culture. Exp Mol Pat-hol 1965; 76: 1-10. 2.Mandell GL, Bennett JE, Dolin R. Principles and practice ofinfectious diseases. 8th ed. Philadelphia: Churchill Livings-tone, 2015: 1738-53. 3.Britt W. Cytomegalovirus. In: Remington JS, Klein JO, WilsonCB, Baker CJ (eds). Infectious Diseases of the Fetus and New-born Infant, 7th ed. Elsevier Saunders: Philadelphia, 2011: 706. 4.Harrison GJ. Cytomegalovirus. In: Cherry JD, Harrison GJ,Kaplan SL, et al (eds). Feigin and Cherry’s Textbook of Pe-diatric Infectious Diseases, 7th ed. Elsevier Saunders: Phila-delphia, 2014: 1969. 5.Mocarski ES, Jr. Immunomodulation by Cytomegaloviruses:manipulative strategies beyond evasion. Trends Microbiol2002; 10: 332-39. 6.Hizel S, Parker S, Onde U. Seroprevalence of cytomegalovi-rus infection among children and females in Ankara, Turkey,1995. Pediatr Int 1999; 41: 506-509. 7.Kenneson A, Cannon MJ. Review and meta-analysis of the epi-demiology of congenital cytomegalovirus (CMV) infection. RevMed Virol 2007; 17: 253-76. 8.Cannon MJ. Congenital cytomegalovirus (CMV) epidemiologyand awareness. J Clin Virol 2009; 46 Suppl 4: S6-10. 9.American Academy of Pediatrics. Cytomegalovirus infection.In: Kimberlin DW (ed). Red Book: 2015 Report of the Com-mittee on Infectious Diseases, 30th, American Academy of Pe-diatrics: Elk Grove Village, IL, 2015: 317. 10.Boppana SB, Ross SA, Fowler KB Congenital cytomegalovirus infec-tion: clinical outcome. Clin Infect Dis 2013; 57 (Suppl 4): S178-81. 11.Boppana SB, Fowler KB, Vaid Y, et al. Neuroradiographic fin-dings in the newborn period and long-term outcome inchildren with symptomatic congenital cytomegalovirus infection. Pediatrics 1997; 99: 409-14. 12.Fowler KB, McCollister FP, Dahle AJ, Boppana S, Britt WJ,Pass RF. Progressive and fluctuating sensorineural hearingloss in children with asymptomatic congenital cytomegalovi-rus infection. J Pediatr 1997; 130: 624-30. 13.Fowler KB, Boppana SB. Congenital cytomegalovirus (CMV)infection and hearing deficit. J Clin Virol 2006; 35: 226-31. 14.Goderis J, De Leenheer E, Smets K, Van Hoecke H, Keymeu-len A, Dhooge I. Hearing loss and congenital CMV infection:a systematic review. Pediatrics 2014; 13: 972-82. 15.Grosse SD, Ross DS, Dollard SC. Congenital cytomegalovirus(CMV) infection as a cause of permanent bilateral hearing loss:a quantitative assessment. J Clin Virol 2008; 41: 57-62. 16.Michaels MG, Greenberg DP, Sabo DL, Wald ER. Treatmentof children with congenital cytomegalovirus infection with gan-ciclovir. Pediatr Infect Dis J 2003; 22: 504-509. 17.Oliver SE, Cloud GA, Sánchez PJ, et al. Neurodevelopmen-tal outcomes following ganciclovir therapy in symptomatic con-genital cytomegalovirus infections involving the central ner-vous system. J Clin Virol 2009; 46 (Suppl 4): S22-26. 18.Townsend CL, Forsgren M, Ahlfors K, Ivarsson SA, TookeyPA, Peckham CS. Long-term outcomes of congenital cytome-galovirus infection in Sweden and the United Kingdom. ClinInfect Dis 2013; 56: 1232-39.
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Details

Primary Language Turkish
Journal Section makale
Authors

Dr. Evrim Kıray Baş This is me

Publication Date November 8, 2016
Published in Issue Year 2016 Volume: 8 Issue: 6

Cite

APA Kıray Baş, D. E. (2016). Konjenital Sitomegalovirus (CMV) Enfeksiyonu. Klinik Tıp Pediatri Dergisi, 8(6), 5-9.
AMA Kıray Baş DE. Konjenital Sitomegalovirus (CMV) Enfeksiyonu. Pediatri. November 2016;8(6):5-9.
Chicago Kıray Baş, Dr. Evrim. “Konjenital Sitomegalovirus (CMV) Enfeksiyonu”. Klinik Tıp Pediatri Dergisi 8, no. 6 (November 2016): 5-9.
EndNote Kıray Baş DE (November 1, 2016) Konjenital Sitomegalovirus (CMV) Enfeksiyonu. Klinik Tıp Pediatri Dergisi 8 6 5–9.
IEEE D. E. Kıray Baş, “Konjenital Sitomegalovirus (CMV) Enfeksiyonu”, Pediatri, vol. 8, no. 6, pp. 5–9, 2016.
ISNAD Kıray Baş, Dr. Evrim. “Konjenital Sitomegalovirus (CMV) Enfeksiyonu”. Klinik Tıp Pediatri Dergisi 8/6 (November 2016), 5-9.
JAMA Kıray Baş DE. Konjenital Sitomegalovirus (CMV) Enfeksiyonu. Pediatri. 2016;8:5–9.
MLA Kıray Baş, Dr. Evrim. “Konjenital Sitomegalovirus (CMV) Enfeksiyonu”. Klinik Tıp Pediatri Dergisi, vol. 8, no. 6, 2016, pp. 5-9.
Vancouver Kıray Baş DE. Konjenital Sitomegalovirus (CMV) Enfeksiyonu. Pediatri. 2016;8(6):5-9.