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Congenital cytomegalovirus
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Congenital cytomegalovirus

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CMV - congenital; Congenital CMV; Cytomegalovirus - congenital

Congenital cytomegalovirus is a group of symptoms that occur when an infant is infected with the cytomegalovirus (CMV) before birth.

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  • Causes

    Congenital cytomegalovirus occurs when an infected mother passes CMV to the fetus through the placenta. The mother's illness may not have symptoms, so she may be unaware that she has CMV.

  • Symptoms

    Most congenitally infected children do not have symptoms. Only about 1 out of 10 infants congenitally infected with CMV have these symptoms:

    • Inflammation of the retina
    • Jaundice
    • Large spleen and liver
    • Low birth weight
    • Mineral deposits in the brain
    • Rash at birth (petechiae)
    • Seizures
    • Small head size (microcephaly)
  • Exams and Tests

    During the exam, the health care provider may find:

    • Abnormal breath sounds indicating pneumonia
    • Enlarged liver
    • Enlarged spleen
    • Psychomotor retardation

    Tests include:

    • Antibody titer against CMV for both the mother and infant
    • Bilirubin level and blood tests for liver function
    • CBC
    • CT scan or ultrasound of the head
    • Fundoscopy
    • TORCH screen
    • Urine culture for CMV virus in the first 2 to 3 weeks of life
    • X-ray of the chest
  • Treatment

    There is no specific treatment for congenital CMV. Treatments, such as physical therapy and appropriate education for children with psychomotor retardation, focus on specific problems.

    Treatment with antiviral medications, such as the drug ganciclovir, is often used for infants with neurologic symptoms. It may reduce hearing loss later in the child's life.

  • Outlook (Prognosis)

    Up to 90% of infants who have symptoms of their infection at birth will have neurologic abnormalities later in life. Only about 5 to 10% of infants without symptoms will have these problems.

    Some children may die while they are an infant.

  • Possible Complications

    • Psychomotor retardation
    • Vision problems or blindness 
    • Deafness
  • When to Contact a Medical Professional

    Have your baby checked right away if he or she was not examined by a health care provider shortly after birth and you suspect that the head is small or you notice other symptoms of congenital CMV.

    If your baby has congenital CMV, it is important to follow the health care provider's recommendations for well-baby examinations. That way, any growth and development problems can be identified early, and treated promptly.

  • Prevention

    Cytomegalovirus is almost everywhere in the environment. The U.S. Centers for Disease Control and Prevention (CDC) recommend the following steps to reduce the spread of CMV:

    • Wash hands with soap and water after touching diapers or saliva.
    • Avoid kissing children under the age of 6 on the mouth or cheek.
    • Do not share food, drinks, or eating utensils with young children.
    • Pregnant women working in a day care center should work with children older than age 2 1/2.

Related Information

  AsymptomaticRashesRetinaCalcificationHearing loss    

References

Crumpacker CS II, Zhang JL. Cytomegalovirus. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, PA: Elsevier Churchill Livingstone; 2009:chap 138.

Swanson EC. Congenital cytomegalovirus infection: new prospects for prevention and therapy. Pediatr Clin North Am. 2013 April 1; 60(2):335-49.

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Review Date: 5/10/2013  

Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Assistant Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.

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