Cytomegalovirus infection in children Custom Search The cytomegalovirus usually causes a minor illness in otherwise healthy children but can result is serious disease when transmitted from a pregnant woman to the developing fetus. Congenital CMV infection:The severity of damage to the fetus depends on the time of infection. If the fetus is infected during the first half of intrauterine life the damage can be considerable. The risk is higher if the mother is exposed to the virus for the first time during pregnancy. Re-infection during pregnancy carries less risk. Fortunately majority of babies born to CMV infected mothers do not suffer from any illness. Severely affected babies may be symptomatic at birth. They are usually small for gestational age. Other manifestations are poor feeding, decreased muscle tone, jaundice, enlargement of liver and spleen, small head and unstable temperature. Many babies have skin rash caused by bleeding into the skin resulting from decreased number of platelets. Convulsions can also occur due to brain damage. Inflammation of the retina and choroid can impair vision. A characteristic finding in congenital CMV infection is calcification around the ventricles of brain. Some babies succumb to the illness. Survivors may suffer from mental retardation, epilepsy, poor vision or hearing loss. Even those who do not have any symptoms or signs at birth may suffer from hearing loss. Laboratory findings: Severely ill babies may have anemia, decreased platelets and increased serum bilirubin. Liver enzymes may be elevated. Examination of cerebrospinal fluid may show increased protein and cells. Virus can be isolated from saliva or urine. Specific anti-CMV IgM antibodies may be demonstrated. CT scan may show calcification and enlargement of ventricles of brain. Congenital CMV infection may resemble congenital toxoplasmosis, congenital rubella, herpes simplex and syphilis. Other conditions which may mimic CMV are bacterial sepsis, metabolic diseases and intracranial bleeding. Treatment: For severely ill babies an antiviral gancyclovir is recommended for about 3 weeks. Damage to brain may not be totally reversible. Severe anemia or thrombocytopenia may need transfusion. Anticonvulsants are given for seizures. Perinatal cytomegalovirus infection: The infection can also be acquired during birth as the virus may be present in the secretions of birth canal or after birth through breast milk. Majority of such babies do not suffer from any clinical illness even through they excrete the virus. Some babies may have enlarged liver, spleen and lymph nodes. Infection of lungs is another finding. Infection can also occur due to transfusion of blood products containing CMV for some other illness. Treatment: Mild infection may not require any treatment. Severe lung infection may necessitate oxygen administration. Those babies who are seriously ill may require gancyclovir. Cytomegalovirus infection in later life:Children can get readily infected from friends as the virus continues to be excreted in saliva and urine for a long time. Adolescents may acquire the infection through sexual activity. Blood transfusion and organ transplantation are other modes of infection. Custom Search
Page last reviewed on 29th May 2010
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