Congenital cytomegalovirus infection

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at September 27, 2016
StartDiseasesCongenital cytomegalovirus infection

Congenital cytomegalovirus (CMV) infection occurs when an infant is born with a cytomegalovirus (CMV) infection. It is a type of congenital disorder and intrauterine infection.

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Definition & Facts

Congenital cytomegalovirus occurs in women who are infected with herpesvirus 5. Some women experience symptoms, but many expectant mothers have no symptoms to alert them of the presence of CMV.

The longterm outlook for babies born with cytomegalovirus infection varies greatly depending on the severity of the infection. Babies who show few signs and symptoms at birth, often go on to live full lives with no exacerbation in symptoms. However, this infection can lie dormant in the body and reactivate at anytime later in life.

It is also possible to be infected again later on with another form of the virus. In severe cases, babies born with severe symptoms associated with congenital cytomegalovirus infection, may die shortly after birth.

Symptoms & Complaints

Babies born with congenital cytomegalovirus may have minor health issues or serious medical conditions that persist for a lifetime. According to the Center for Disease Control or CDC, this infection occurs in approximately 1 out of every 150 births.

However, not all of those infants will become sick from the virus. Serious health problems have been reported in 1 out of 5 babies with congenital cytomegalovirus. Below are the most common symptoms seen in infants born with this infection:

Some symptoms associated with congenital cytomegalovirus do not manifest until the child is older. A percentage of babies infected with this virus have intellectual disability. Some signs of this condition include:

hile many women have no symptoms of this infection, those who do often report:

In addition to a variety of medical complications, babies infected with CMV are more likely to be miscarried or stillborn. There is also an increased likelihood of death shortly after birth

Causes

The cause of congenital cytomegalovirus infection is transmission by a mother with the viral infection. The mother can contract the virus through both sexual and non-sexual contact. It can be spread through contact with body fluids such as semen, feces, blood, cervical mucus, or saliva.

Certain women are at an increased risk of developing CMV. Women who work in childcare or as teachers are more likely to come into contact with the virus. In addition, healthcare workers and women with young children are also at an increased risk. 

Diagnosis & Tests

If cytomegalovirus is suspected in a pregnant woman, her doctor will perform a blood test to confirm it. If the blood test comes back positive, doctors may perform an amniocentesis for confirmation. This test is done by introducing a needle into the womb through the stomach and taking a small sample of amniotic fluid for analysis. Since this virus is not routinely screened for during pregnancy and many women have no symptoms, it is often not diagnosed until the baby is born. 

Some babies are born with a severe form of infection, evidenced by a purple-colored rash all over the body. If this rash is not present, doctors will test for the infection in babies who are sick at birth. Most doctors use clinical urine tests to diagnose CMV in newborns as part of newborn screening.

Blood tests may also be done at this time, to determine if any other infections are present. Blood tests such as a complete blood count or CBC and a bilirubin screening may be done. If CMV affects the retina at birth, a pediatric ophthalmologist will examine the structures in the eye for signs of the infection. 

Other tests may also be performed to diagnose conditions related to CMV shortly after birth. A computed tomography (CT) scan, medical ultrasound or X-ray series are also common. 

Treatment & Therapy

The treatment for congenital cytomegalovirus infection depends on the severity of the condition and the body parts affected. Infants are typically treated with antiviral drugs, especially in those with retina symptoms.

Physical therapy and speech therapy may be prescribed for children who have delayed movements, slow speech or diminished intellectual capacity. Therapy often teaches both parents and children how to cope with physical disabilities and cognitive deficit that often affect children born with congenital cytomegalovirus infection. Special education and occupational therapy may also be a part of treatment.

Prevention & Prophylaxis

While it is not always possible to prevent cytomegalovirus infection, there are ways pregnant women can reduce the risks. Some ways to prevent contracting this infection include:

  • Hand washing after diaper changes or wiping noses
  • Not sharing drinks or food with young children or those infected with CMV
  • Practicing safe sex by using a condom when having sex with a partner infected with the virus
  • Avoiding kissing children on the mouth

Mothers with children born with congenital cytomegalovirus infection must take their children to all doctor's visits and closely monitor their progress. This is extremely important, even if the child does not have obvious symptoms of CMV.

Those who survive may have serious defects that affect many parts of the body including the eyes, brain, lungs, liver, spleen or ears. Babies who have weakened immune symptoms from other infections such as HIV may also have ongoing medical issues related to CMV throughout their lives. 

During doctor's visits, doctors measure the growth rate of the child to be sure he or she is not failing to thrive. He will also be sure the baby is reaching his developmental milestones such as sitting up, crawling and walking on time. Early detection and diagnosis are key to combating the effects of this infection as the child grows.