Cytomegalovirus infections in children

Abstract

Introduction. Cytomegalovirus Infection (CMV) is one the most common congenital viral infection and an important public health issue, which is widely spread in newborns, about 0.3% - 2.4%,characterized by symptomatic infection, clinical polymorphism, severe evolution and irreversible sequelae (mental retardation, hepatitis and deafness), persistent viral infections Associated with risks of reactivation of immunosuppressed states. The objective of the research is to study and highlight the clinical and diagnostic peculiarities of CMV infection in infants and young children. Materials and methods. A retrospective study was performed on a group of 42 children at ages 1month-3years, most of them (29 children-69%) aged under 12 months were from rural areas. Presenceof specific anti CMV IgM and IgG (ELISA test) in serum and CMV DNA in serum or urine by means of PCR were confirmed in diagnosing CMV infection. Results. The study results proved the presence of high risk perinatal factors for antenatal fetal infection in over 53% of pregnant women: area of origin, low socioeconomic level, previous abortions or mortality cases, infections during pregnancy, premature births in medical history. The current gestation ended with premature birth in 10 (23%) cases, 12 cases of born at term infants (35.5%) showed retarded intrauterine development. The clinical features of congenital CMV infection was multiformelike. The reason for hospitalization was neurological, pulmonary and liver impairment. Neurological examination revealed the presence of a neuro-psychological retardation of varying degrees in 21 (50%) cases, periventricular calcifications in 10 (23.8%) children, microcephaly in 5 (12%) children. Liver damage was characterized by hepatosplenomegaly and cytolisis in 2/3 of children. The ophthalmologic examination revealed chorioretinitis in 5 (12%) children and optic nerve atrophy in 2 children. One child was diagnosed with sensorineural deafness. Most children suffered from interstitial lung- pneumonia. The disease diagnosis was confirmed by the presence of CMV-DNA in the serum of 7 children out of 11 investigations and DNA in the urine of 10 children out of 11 investigated ones. The serologic test results were positive for CMV IgM antibodies in 23 (55%) cases and anti CMV IgG in 27 (64%) cases. Conclusions. According to the survey, more than 53% of cases resulted from pathological pregnancies. Interstitial pneumonia, hepatomegaly and cytolisis, periventricular calcification and microcephaly, chorioretinitis and optic nerve atrophy were the most common clinical manifestations of congenital CMV infection. The serologic positive results confirmed the diagnosis by presence of CMV IgM and IgG antibodies and CMV DNA in serum or urine.