SYMPTOMATIC CONGENITAL CYTOMEGALOVIRUS-INFECTION - NEONATAL MORBIDITY AND MORTALITY

被引:400
|
作者
BOPPANA, SB [1 ]
PASS, RF [1 ]
BRITT, WJ [1 ]
STAGNO, S [1 ]
ALFORD, CA [1 ]
机构
[1] UNIV ALABAMA, SCH MED, DEPT MICROBIOL, BIRMINGHAM, AL 35294 USA
关键词
CYTOMEGALOVIRUS; CONGENITAL INFECTION; NEONATAL MORBIDITY;
D O I
10.1097/00006454-199202000-00007
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Knowledge of the natural history of symptomatic congenital cytomegalovirus (CMV) infection in the newborn is essential in order to anticipate complications and assess the potential benefit from antiviral therapy. To define the disease course we reviewed data on 106 neonates with symptomatic congenital CMV infection diagnosed and managed by the investigators. Petechiae, jaundice and hepatosplenomegaly were each noted in 70% or more patients. Microcephaly was noted in 54 of 102 (53%) at birth. Elevated alanine aminotransferase, conjugated hyperbilirubinemia and thrombocytopenia were seen in 83, 81 and 77%, respectively. Eighty-six percent had at least two of the manifestations highly suggestive of congenital infection. Platelet count fell to its nadir during the second week of life whereas elevated alanine aminotransferase and direct bilirubin persisted past the first month. In spite of the difficulty in assessing central nervous system function in the newborn, evidence of damage was present in the majority. Seventy-two had microcephaly, poor suck, lethargy/hypotonia or seizures. Abnormal computerized tomographic scan was present in 16 of 20 (80%) and decreased hearing in 20 of 39 (56%). Cerebrospinal fluid protein was > 120 mg/dl in 24 of 52 (46%) and this elevation was associated with neurologic abnormalities as well as hearing loss. The mean length of hospital stay was 13 and 22.4 days for term and preterm infants, relatively. Thirteen infants (12%) died during the first 6 weeks of life. Disseminated CMV infection with multiorgan involvement was evident in 7 of 9 at postmortem examination. We conclude that neonates with symptomatic congenital CMV infection have a multi-system disease with significant morbidity and mortality.
引用
收藏
页码:93 / 99
页数:7
相关论文
共 50 条
  • [21] CYTOMEGALOVIRUS-INFECTION IN 2 INFANTS WITH CONGENITAL OR NEONATAL SOLID TUMORS
    NIGRO, G
    BARTMANN, U
    PROPERZI, E
    TORRE, A
    SCHIAVETTI, A
    CASTELLO, M
    PEDIATRIC HEMATOLOGY AND ONCOLOGY, 1993, 10 (04) : 351 - 355
  • [22] Diagnosis of congenital Cytomegalovirus-Infection
    不详
    GYNAKOLOGE, 2018, 51 (06): : 449 - 449
  • [23] CONGENITAL CYTOMEGALOVIRUS-INFECTION IN JAPAN
    CHIBA, S
    KAMADA, M
    YOSHIMURA, H
    HIRAKI, M
    NAKAO, T
    KOMORI, A
    NEW ENGLAND JOURNAL OF MEDICINE, 1984, 310 (01): : 50 - 50
  • [24] CYCLOPIA AND CONGENITAL CYTOMEGALOVIRUS-INFECTION
    BYRNE, PJ
    SILVER, MM
    GILBERT, JM
    CADERA, W
    TANSWELL, AK
    AMERICAN JOURNAL OF MEDICAL GENETICS, 1987, 28 (01): : 61 - 65
  • [25] CONGENITAL CYTOMEGALOVIRUS-INFECTION - A DILEMMA
    TIMBURY, MC
    BRITISH MEDICAL JOURNAL, 1984, 289 (6447): : 712 - 713
  • [26] CONGENITAL CYTOMEGALOVIRUS-INFECTION - REPLY
    GRIFFITHS, PD
    NEW ENGLAND JOURNAL OF MEDICINE, 1982, 307 (16): : 1023 - 1023
  • [27] EPIDEMIOLOGY OF CONGENITAL CYTOMEGALOVIRUS-INFECTION
    SOUZA, IE
    BENSON, P
    ONEILL, ME
    MURPH, JR
    BALE, JF
    ANNALS OF NEUROLOGY, 1994, 36 (03) : 528 - 528
  • [28] DIAGNOSIS OF CONGENITAL CYTOMEGALOVIRUS-INFECTION
    GOLD, E
    JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 1980, 244 (10): : 1148 - 1148
  • [29] A Prognostic Neonatal Neuroimaging Scale for Symptomatic Congenital Cytomegalovirus Infection
    Alarcon, Ana
    Martinez-Biarge, Miriam
    Cabanas, Fernando
    Quero, Jose
    Garcia-Alix, Alfredo
    NEONATOLOGY, 2016, 110 (04) : 277 - 285
  • [30] Treatment of symptomatic congenital cytomegalovirus infection beyond the neonatal period
    del Rosal, Teresa
    Baquero-Artigao, Fernando
    Blazquez, Daniel
    Noguera-Julian, Antoni
    Moreno-Perez, David
    Reyes, Alejandro
    Vilas, Javier
    JOURNAL OF CLINICAL VIROLOGY, 2012, 55 (01) : 72 - 74