Last modified: 2018-09-09
Abstract
Objective: To describe the neurologic phenotypes associated with congenital CMV infection.
Background: Cytomegalovirus (CMV) is a ubiquitous agent, that causes a primary or secondary infection in pregnant women. Infection in the fetus and newborn is chronic, with CMV recoverable months to years after birth. Children with congenital CMV (cCMV) may appear normal at birth, with neurologic symptoms presenting later in life.
Methods: Retrospective chart review of the cohort of children with cCMV, from April 2005 to February 2016, referred to the CMV Speciality Clinic at a tertiary care pediatric hospital.
Results: 151 children were identified with cCMV. 47 (31%) of these had abnormal neuroimaging; 17 of 47 (11%) of these had isolated neurologic phenotypes. Chief complaints were hearing loss (35%), vision impairment (47%), motor delays (65%), language deficits (77%), microcephaly (29%) and seizures (24%). Neuroimaging findings were intracranial calcifications (35%), cysts (41%), abnormal white matter (77%), migrational abnormalities (47%) and cerebellar abnormality (6%). 13 of the 17 children (ages 2 to 33 months) were confirmed retrospectively by dried blood spot (DBS).
Discussion: Characterization of the neurologic phenotypes and imaging findings of cCMV is needed, as these may present beyond the neonatal period. Early recognition of cCMV with appropriate treatment may improve neurodevelopmental outcomes. Universal newborn screening for cCMV would identify these infants in the newborn period.