Congenital CMV

Question 1

What is congenital CMV?

Answer 1

When a baby is born with cytomegalovirus infection

Question 2

How common is congenital CMV?

Answer 2

Occurs in 1/200 births

Question 3

What proportion of babies born with congenital CMV have long term health problems?

Answer 3

1/5

Question 4

CMV is a member of what virus family?

Answer 4

Herpes virus

Question 5

How does CMV infection commonly affect adults?

Answer 5

Usually asymtpomatic

Question 6

What can CMV cause in neonates?

Answer 6

Severe illness

Question 7

How does a baby develop congenital CMV?

Answer 7

If the mother has CMV during pregnancy either as a first time infection or after a previous infection

Question 8

How is the CMV passed to the unborn baby?

Answer 8

Via the placenta

Question 9

How can CMV be transmitted postnatally?

Answer 9

Through breast milk or saliva

Question 10

What signs of congenital CMV may be present at birth?

Answer 10

• Rash
• Jaundice
• Microcephaly
• IUGR
• Hepatosplenomegaly
• Seizures
• Retinitis

Question 11

How is diagnosis of congenital CMV made?

Answer 11

PCR amplification of viral DNA

Question 12

What samples can be used for PCR?

Answer 12

• Amniotic fluid
• Fetal blood
• Infants blood, urine, CSF, saliva

Question 13

What are the differentials for congenital CMV?

Answer 13

Other congenital infections

Question 14

What is the management for congenital CMV?

Answer 14

Antiviral therapy with oral valganciclovir for 6 months

Question 15

What has 6 months of valganciclovir been shown to do?

Answer 15

Improve hearing and neurodevelopmental outcomes

Question 16

What should all infants with CMV be followed up for?

Answer 16

Late onset sensorineural hearing loss until school age

Question 17

What can congenital CMV lead to in the most severe cases?

Answer 17

Pregnancy loss

Question 18

What long term complications can occur as a result of congenital CMV?

Answer 18

• Hearing loss
• Developmental and motor delay
• Vision loss
• Microcephaly
• Seizures