RISK FACTORS: HIV infection, AIDS, Organ transplantation (50% attack rate, depending on
serologic status), Blood transfusion. A postperfusion syndrome may develop in 2 to 4 weeks
* - Congenital CMV infection is the most common congenital viral infection and results in intrauterine growth restriction, sensorineural hearing loss, intracranial calcifications, microcephaly, hydrocephalus, hepatosplenomegaly, delayed psychomotor development, and optic atrophy. Most infections (90%) cause no symptoms, but 10% cause microcephaly, thrombocytopenia, hepatosplenomegaly, intrauterine growth restriction, or a combination thereof. Of those who survive infancy, half eventually develop microcephaly, mental retardation, and sensorineural hearing loss. Seven percent of asymptomatic neonates develop sensorineural hearing loss or developmental delays during the first 2 years of life (Boppana, 2001; Trincado, 2001; Gaytant, 2002; Lipitz, 2002; Pass, 2002). Five percent eventually develop microcephaly and neuromuscular defects, and 2% develop chorioretinitis.
DRUG(S) OF CHOICE :
β’ Valacyclovir - oral prophylaxis in adult bone marrow transplant recipients (neutropenia)
β’ Ganciclovir - nucleoside analog that is virostatic; useful in all ages; IV or oral
β’ Foscarnet - adult CMV illnesses (renal toxicity)
β’ Cidofovir - adult CMV illnesses (nephrotoxicity)
PATIENT MONITORING :Close followup in ICU (isolated) during infection with disseminated form
PREVENTION/AVOIDANCE : Avoid immunosuppression (when possible)
POSSIBLE COMPLICATIONS :
β’ Chorioretinitis
β’ Encephalitis
β’ Mononucleosis
β’ Colitis
β’ Deafness
β’ Mental retardation
EXPECTED COURSE/PROGNOSIS :
Disseminated form often fatal