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Evaluation of clinically asymptomatic high risk infants with congenital cytomegalovirus infection

Journal of Perinatology volume 40, pages 89–96 (2020)Cite this article

Subjects

Abstract

Objective

To determine the frequency of abnormal findings on evaluation of neonates with congenital CMV infection who have a normal physical examination

Study design

Retrospective, 2-center study (1996–2017) that reviewed results of complete blood cell count and platelets, serum alanine aminotransferase (ALT) and bilirubin concentrations, eye examination, cranial ultrasonography or other neuroimaging, and brainstem evoked responses performed on neonates with congenital CMV infection and a normal physical examination

Results

Of 34 infants with congenital CMV infection and a normal physical examination, 56% (19/34) had ≥1 abnormality: 39%, elevated ALT concentration; 45%, abnormal neuroimaging (five, lenticulostriate vasculopathy; six, intraventricular hemorrhage; four, calcifications); 12%, anemia; 16%, thrombocytopenia; and 3%, chorioretinitis. Seven (21%) infants had sensorineural hearing loss, and 18 infants received antiviral therapy.

Conclusion

Some infants with congenital CMV infection and a normal physical examination had abnormalities on laboratory or neuroimaging evaluation, which in some cases prompted antiviral treatment.

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Funding

AR received grant support from “A. Griffini—J. Miglierina” Fundation—Provincia di Varese Piazza Libertà 1- 21100 Varese-Italy. The Fundation was not involved in the (1) study design, (2) the collection, analysis, and interpretation of data; (3) the writing of the report; and (4) the decision to submit the paper for publication. AR wrote the first draft of the paper. The other authors have no financial relationships relevant to this article to disclose.

Author information

Authors and Affiliations

  1. Departments of Pediatrics, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Andrea Ronchi, Lizette E. Lee, Joseph B. Cantey, Shawn Varghese & Pablo J. Sánchez

  2. Neonatal Intensive Care Unit, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy

    Andrea Ronchi, Lorenza Pugni & Fabio Mosca

  3. Children’s Medical Center, Dallas, TX, USA

    Andrea Ronchi, Fiker Zeray, Lizette E. Lee, Kris E. Owen, Angela G. Shoup, Joseph B. Cantey & Pablo J. Sánchez

  4. Parkland Health & Hospital System, Dallas, TX, USA

    Andrea Ronchi, Fiker Zeray, Lizette E. Lee, Kris E. Owen, Angela G. Shoup, Joseph B. Cantey & Pablo J. Sánchez

  5. Departments of Otolaryngology, University of Texas Southwestern Medical Center, Dallas, TX, USA

    Kris E. Owen & Angela G. Shoup

  6. Fundación del Centro de Estudios Infectológicos, Buenos Aires, Argentina

    Fabiana Garcia & Liliana N. Vazquez

  7. University of Milan, Department of Clinical Sciences and Community Health, Milano, Italy

    Fabio Mosca

  8. Pediatrics, Divisions of Neonatology and Pediatric Infectious Diseases, Nationwide Children’s Hospital, The Ohio State University College of Medicine, Center for Perinatal Research, Abigail Wexner Research Institute at Nationwide Children’s Hospital, Columbus, OH, USA

    Pablo J. Sánchez

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  1. Andrea Ronchi
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Contributions

AR, had full access to all study data and is responsible for the data integrity and accuracy of the data analysis. He participated in the study concept and design, acquisition of data, analysis and interpretation of data, initial and subsequent drafts of the paper, and approved the final paper as submitted. FZ, participated in the study concept and design, acquisition of data, critical revision of the paper, and approved the final paper as submitted. LE.L, participated in the study concept and design, acquisition of data, critical revision of the paper, and approved the final paper as submitted. KE.O, participated in the study design, acquisition of data, critical revision of the paper, and approved the final paper as submitted. AG.S, participated in the study concept and design, acquisition of data, critical revision of the paper, and approved the final paper as submitted. FG, had full access to all study data and is responsible for the data integrity and accuracy of the data analysis. She participated in the study concept and design, acquisition of data, analysis and interpretation of data, initial and subsequent drafts of the paper, and approved the final paper as submitted. LN.V, had full access to all study data and is responsible for the data integrity and accuracy of the data analysis. She participated in the study concept and design, acquisition of data, analysis and interpretation of data, initial and subsequent drafts of the paper, and approved the final paper as submitted. JB.C, had full access to all study data and is responsible for the data integrity and accuracy of the data analysis. He participated in the study concept and design, acquisition of data, analysis and interpretation of data, initial and subsequent drafts of the paper, and approved the final paper as submitted. SV, participated in the acquisition of data, critical revision of the paper, and approved the final paper as submitted. LP, supervised the overall study by analysis and interpretation of data, critical revision of the paper for important intellectual content, and approved the final paper as submitted. FM, supervised the overall study by analysis and interpretation of data, critical revision of the paper for important intellectual content, and approved the final paper as submitted. PJ.S, had full access to all study data and is responsible for the data integrity and accuracy of the data analysis. He supervised the overall study by developing the study concept and design, acquisition of data, analysis and interpretation of data, initial and subsequent drafts of the paper, and approved the final paper as submitted.

Corresponding author

Correspondence to Pablo J. Sánchez.

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The authors declare that they have no conflict of interest.

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The study was presented in part at the 4th Congenital Cytomegalovirus Conference, San Francisco, CA, October 29–31, 2012, and at the Pediatric Academic Societies’ Annual Meeting, Vancouver, BC, May 3–6, 2014

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Ronchi, A., Zeray, F., Lee, L.E. et al. Evaluation of clinically asymptomatic high risk infants with congenital cytomegalovirus infection. J Perinatol 40, 89–96 (2020). https://doi.org/10.1038/s41372-019-0501-z

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