Congenital cytomegalovirus

• Illustrations
• Alternative names
• Definition
• Causes, incidence, and risk factors
• Symptoms
• Signs and tests

• Treatment
• Expectations (prognosis)
• Complications
• Calling your health care provider
• Prevention

Alternative names    Return to top

Definition    Return to top

Congenital cytomegalovirus is a cluster of findings associated with infection of the fetus by cytomegalovirus.

Causes, incidence, and risk factors    Return to top

Congenital cytomegalovirus is caused when an infected mother passes CMV virus to the fetus through the placenta. The mother's illness may be subclinical (without symptoms or asymptomatic), and she may be unaware that any problems exist.

The majority of congenitally infected children are asymptomatic. The symptomatic infant is characteristically born with a petechial rash (a rash that looks like fine purplish-colored dots), a large spleen and liver, jaundice, inflammation of the retina, intracranial calcifications (mineral deposits within the brain), and a small head (microcephaly).

Only about 1 out of 10 infants congenitally infected with CMV are thought to exhibit these symptoms.

Symptoms    Return to top

• Low birth weight
• Small head size (microcephaly)
• Seizures
• Rash at birth (petechiae)
• Jaundice

Signs and tests    Return to top

In examining the body, the health care provider, may also find:

• enlarged liver
• enlarged spleen
• Abnormal breath sounds indicating pneumonia
• Psychomotor retardation

Tests include:

• Urine culture for CMV virus in the first 2-3 weeks of life
• Antibody titer against CMV for both the mother and infant
• CT scan or ultrasound of the head (which can show cerebral calcifications if they are present)
• Bilirubin level and blood tests for liver function (to assess the extent of jaundice and liver involvement)
• Fundoscopy (which may show chorioretinitis)
• CBC (which may show anemia)
• X-ray of the chest (which may show pneumonia)
• TORCH screen

Treatment    Return to top

There is no specific treatment for congenital CMV. Treatment focuses on specific problems such as physical therapy and appropriate schooling of children with psychomotor retardation. Experimental treatment with the drug ganciclovir may reduce hearing loss that infected infants suffer later in life.

Expectations (prognosis)    Return to top

Between 45-90% of infants who have symptoms of their infection at birth will have neurologic abnormalities later in life, while only about 15% of infants without symptoms will have these problems.

Complications    Return to top

• Psychomotor retardation
• Deafness

Calling your health care provider    Return to top

Have the baby examined promptly if your baby was not examined by a health care provider shortly after birth and you suspect that the head is small or if other symptoms of congenital CMV are present.

If your baby has congenital CMV, it is important to follow the health care provider's recommendations for well-baby examinations. That way, any growth and development problems can be identified early, and appropriate therapy can begin promptly.

Prevention    Return to top

Cytomegalovirus is almost everywhere in the environment, and is almost impossible to avoid.