Congenital Cytomegalovirus (CMV) Infection

Yıl 2016, Cilt: 8 Sayı: 6, 5 - 9, 08.11.2016

Dr. Evrim Kıray Baş

Öz

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.

Anahtar Kelimeler

Congenital infections, cytomegalovirus, sensorineural hearing loss

Konjenital Sitomegalovirus (CMV) Enfeksiyonu

Öz

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.

Anahtar Kelimeler

Konjenital enfeksiyon, sitomegalovirus, sensörinöral işitme kaybı

Kaynakça

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