Case report Treatment of symptomatic congenital cytomegalovirus infection with ganciclovir

Abdelmoneim E.M. Kheir, Ayaa M.E. Barri, Iman A. Wadi, Nahid S. Abbadi

Abstract


Cytomegalovirus (CMV) is the most common cause of congenital infections in humans and it produces
considerable morbidity in newborns. There has been insufficient attention given to congenital CMV infection
in the developing world and the exact prevalence in Sudan is not known. The classical triad of congenital
CMV infection is composed of jaundice, petechiae and hepatosplenomegaly. We report a Sudanese baby
born with the typical symptomatology of congenital Cytomegalovirus infection and positive serological
test who was treated with Ganciclovir for six weeks with complete resolution of hepatic cholestasis and
normal hearing. Currently he has global developmental delay and abnormal CNS examination, his initial
CT brain and follow up MRI brain scan were grossly abnormal which was a predictor of severe intellectual
impairment.

Keywords


Case report; Treatment; symptomatic ;congenital ;cytomegalovirus ;infection; ganciclovir

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References


Schleiss MR. Persistent and recurring viral

infections: the human herpes viruses. Curr

Probl Pediatr Adolesc Health Care 2009; 39:7-

Soderberg-Naucler C. Does cytomegalovirus

play a causative role in the development of

various inflammatory diseases and cancer?. J

Intern Med 2006; 259:219-46.

Stagno S, Britt B. Cytomegalovirus. In:

Remington JS, Klein JO, Wilson CB, Baker

CJ, editors. Infectious diseases of the fetus and

newborn infant. 6th ed. Philadelphia: Elsevier

Saunders, 2006; 740-781.

Schleiss MR. Cytomegalovirus vaccines and

methods of production (WO20009049138):

the emerging recognition of the importance of

virus neutralization at the epithelial/endothelial

interface. Expert Opin Ther Pat 2010; 20:597-

. Kenneson A, Cannon MJ. Review and metaanalysis

of the epidemiology of congenital

cytomegalovirus (CMV) infection. Rev Med

Virol 2007; 17: 253-276.

Dollard SC, Grosse SD, Ross DS. New

estimates of the prevalence of neurological and

sensory sequelae and mortality associated with

congenital cytomegalovirus infection. Rev Med

Virol 2007; 17: 355.

Kimberlin DW, Lin CY, Sánchez PJ, et al.:

Effect of ganciclovir therapy on hearing in

symptomatic congenital cytomegalovirus

disease involving the central nervous system:

a randomized, controlled trial. J Pediatr 2003,

:16-25.

Oliver SE, Cloud GA, Sánchez PJ, et al.:

Neurodevelopmental outcomes following

ganciclovir therapy in symptomatic congenital

cytomegalovirus infections involving the

central nervous system. J Clin Virol 2009, 46:

-6.

Dar L, Pati SK, Patro AR, et al. Congenital

cytomegalovirus infection in a highly

seropositive semi-urban population in India.

Pediatr Infect Dis J. 2008; 27:841-3.

Kenneson A, Cannon MJ. Review and metaanalysisof

the epidemiology of congenital

cytomegalovirus(CMV) infection. Rev Med

Virol 2007; 17: 253-276.

Colugnati FA, Staras SA, Dollard SC, Cannon

MJ. Incidence of cytomegalovirus infection

among the general population and pregnant

women in the United States. BMC Infect Dis.

;7:71.

Revello MG, Zavattoni M, Baldanti F, Sarasini

A, Paolucci S, Gerna G. Diagnostic and

prognostic value of human cytomegalovirus

load and Ig Manti body in blood of congenitally

infected new borns.J Clin Virol 1999; 14: 57-

Conboy TJ, Pass RF, Stagno S, et al. Early

clinical manifestations and intellectual outcome

Abdelmoneim E.M. Kheir, Ayaa M.E. Barri, Iman A. Wadi, Nahid S. Abbadi

in children with symptomatic congenital

cytomegalovirus infection. J Peds 1987; 111:

-348.

Lagasse N, Dhooge I, Govaert P. Congenital

CMV infection and hearing loss. Acta

Otorhinolaryngol Belg 2000; 54: 431-436.

Michaels MG, Greenberg DP, Sabo DL, et

al: Treatment of children with congenital

cytomegalovirus infection with ganciclovir.

Pediatr Infect Dis J 2003; 22:504-509.

Fowler KB, Boppana SB. Congenital

cytomegalovirus(CMV) infection and hearing

deficit. J Clin Virol 2006; 2: 226-231.

Malinger G, Lev D, Zahalka N, et al: Fetal

cytomegalovirus infection of the brain: the

spectrum of sonographic findings. AJNR Am J

Neuroradiol 2003; 24:28-32.

Hocker JR, Cook LN, Adams G, et

al: Ganciclovir therapy of congenital

cytomegalovirus pneumonia. Pediatr Infect Dis

J 1990; 9:743-745.

Noyola DE, Demmler GJ, Nelson CT, et al. Early

predictors of neurodevelopmental outcome

in symptomatic congenital cytomegalovirus

infection. J Pediatr 2001; 138: 325-331.


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