Chakradhar Maddela ¹* and K Venkata Rama Rao²

¹Neonatologist and Echocardiologist, Professor of Pediatrics and Neonatology, Division of NICU-PICU, Department of Pediatrics, MNR Medical College and Hospital, Sangareddy, Telangana, India
²Assistant Professor of Pediatrics, Department of Pediatrics, MNR Medical College and Hospital, Sangareddy, Telangana, India

*Corresponding Author: Chakradhar Maddela, Neonatologist and Echocardiologist, Professor of Pediatrics and Neonatology, Division of NICU-PICU, Department of Pediatrics, MNR Medical College and Hospital, Sangareddy, Telangana, India.

Received: January 17, 2025; Published: January 30, 2025

Abstract

Congenital cytomegalovirus infection (cCMVI) is the most common viral infection during pregnancy, affecting 0.5-1% of live births in the West and three to four-fold increased incidence in Low to middle income countries (LMIC). This retrospective case series study analyzed eleven cases of cCMVI in children under five years, highlighting the clinical spectrum from asymptomatic to full blown clini cal presentation with neurological impairments. Key findings include periventricular calcification, ventriculomegaly and elevated anti-IgG and IgM antibodies. Early detection through universal maternal and neonatal screening combined with serological testing and neurosonogram, is crucial for early detection and intervention in resource limited settings (RLS). Antiviral treatments like Gan ciclovir and valganciclovir show promise in reducing disease severity. The study underscores the importance of maternal education, early therapeutic intervention, and regular follow up to mitigate long term sequelae in affected children.

Keywords: Congenital Cytomegalovirus Infection (cCMVI); Resource Limited Settings (RLS)

References

1. Ssentongo, Paddy., et al. “Congenital cytomegalovirus infection burden and epidemiological risk factors in countries with universal screening: a systematic review and meta-analysis”. JAMA Network Open8 (2021): e2120736-e2120736.
2. Rhonchi A., et al. “Evaluation of clinically asymptomatic high-risk infants with congenital asymptomatic high-risk infants with congenital cytomegalovirus infection”. Journal of Perinatology 40 (2020): 89-96.
3. Leruez-Ville Marianne., et al. “Cytomegalovirus infection during pregnancy: state of the science”. American Journal of Obstetrics and Gynecology3 (2020): 330-349.
4. Lanzieri TM., et al. “Hearing Loss in Children with Asymptomatic Congenital Cytomegalovirus Infection”. Pediatrics3 (2017): e2016 2610.
5. Jenks C M., et al. “Congenital cytomegalovirus infection: epidemiology, timely diagnosis, and management”. Neoreviews (2021).
6. Karamimagham S., et al. “Normal Reference Range of Lateral Ventricle Parameters in Preterm Neonates by Ultrasonography”. Shiraz E-Med Journal8 (2017): e57569.
7. Davies MW., et al. “Reference ranges for the linear dimensions of the intracranial ventricles in preterm neonates”. Archives of Disease in Childhood: Fetal and Neonatal Edition 82 (2000): F218F223.
8. Lervez-Ville M., et al. “Consensus recommendation for prenatal, neonatal, and postnatal management of congenital cytomegalovirus infection from the European congenital infection initiative (ECCI)”. The Lancet 40 (2024).
9. Swanson CE and Schlesinger MR. “Congenital Cytomegalovirus Infection: New Prospects for Prevention and Therapy”. PCNA (2014).
10. World Health Organization, Birth Defects Surveillance: Quick Reference Handbook, WHO-CDC (2020).
11. Jalilsani L., et al. “A New Duplication in 668 to 672 Site of UL54 Gene in Cytomegalovirus Ganciclovir Resistant Liver Transplanted Patients”. Jundishapur Journal of Microbiology9 (2023): e13790.
12. Manicklal S and Emery VC. “The “Silent” Global Burden of Congenital Cytomegalovirus”. Clinical Microbiology Reviews1 (2013): 86-102.
13. Alder SP., et al. “Screening for Cytomegalovirus during Pregnancy: Review Article”. Hindawi Pub Corp Infectious Diseases in Obstetrics and Gynecology (2011): 9.
14. , et al. “Outcome and management of newborns with congenital cytomegalovirus infection”. Archives de Pediatrie 27.3 (2020): 160-165.
15. Bopanna SB., et al. “Symptomatic congenital cytomegalovirus infection: neonatal morbidity and mortality”. The Pediatric Infectious Disease Journal2 (1992): 93-98.
16. Wilson K., et al. “Congenial Cytomegalovirus Infection Presenting with Hyperbilirubinemia and Splenomegaly in a Term Infant with Trisomy 1”. Hindawi Case Reports in Pediatrics (2020): 4.
17. Schlesinger Y., et al. “Urine polymerase chain reaction as a screening tool for the detection of congenital cytomegalovirus infection”. Archives of Disease in Childhood: Fetal and Neonatal Edition 88 (2003): F371-F374.
18. Picone O., et al. “Comparison between ultrasound and magnetic resonance imaging in assessment of fetal cytomegalovirus infection”. Prenatal Diagnostic8 (2008): 7538.
19. Jones Christine E., et al. "Managing challenges in congenital CMV: current thinking”. Archives of Disease in Childhood 8 (2023): 601-607.
20. Suganuma Eisuke., et al. “Efficacy, safety, and pharmacokinetics of oral valganciclovir in patients with congenital cytomegalovirus infection”. Journal of Infection and Chemotherapy2 (2021): 185-191.
21. Ebruke B., et al. “Intracranial Ventricular Sizes And Correlates in Term Nigerian Infants At Birth And Six Weeks”. The Internet Journal of Pediatrics and Neonatology1 (2008).
22. Osterholm EA and Schleiss M R. "Impact of breast milk‐acquired cytomegalovirus infection in premature infants: Pathogenesis, prevention, and clinical consequences?". Reviews in Medical Virology (2020).

Citation

Citation: Chakradhar Maddela and K Venkata Rama Rao. “Congenital Cytomegalovirus Infection in Children: A Retrospective Case Series Study at Resource Limited Setting with Literature Review". Acta Scientific Paediatrics 8.1 (2025): 32-39.

Copyright

Copyright: © 2025 Chakradhar Maddela and K Venkata Rama Rao. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.