Congenital cytomegalovirus
CMV - congenital; Congenital CMV; Cytomegalovirus - congenitalCongenital cytomegalovirus is a condition that can occur when an infant is infected with a virus called cytomegalovirus (CMV) before birth. Congenital means the condition is present at birth.
Causes
Congenital CMV occurs when an infected mother passes CMV to the fetus through the placenta. The mother may not have symptoms, so she may be unaware that she has CMV.
Symptoms
Most children with congenital CMV do not have symptoms. Those who do have symptoms may have:
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Inflammation of the retina
Retina
The retina is the light-sensitive layer of tissue at the back of the eyeball. Images that come through the eye's lens are focused on the retina. Th...
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- Large spleen and liver
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Low birth weight
Low birth weight
Intrauterine growth restriction (IUGR) refers to the poor growth of a baby while in the mother's womb during pregnancy.
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- Rash at birth
- Seizures
- Small head size
Exams and Tests
During the exam, the health care provider may find:
- Abnormal breath sounds indicating pneumonia
Pneumonia
Pneumonia is a breathing (respiratory) condition in which there is an infection of the lung. This article covers community-acquired pneumonia (CAP). ...
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Enlarged liver
Enlarged liver
Enlarged liver refers to swelling of the liver beyond its normal size. Hepatomegaly is another word to describe this problem. If both the liver and ...
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Enlarged spleen
Enlarged spleen
Splenomegaly is a larger-than-normal spleen. The spleen is an organ in the upper left part of the belly.
Read Article Now Book Mark Article - Delayed physical movements (psychomotor retardation)
Tests include:
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Antibody titer against CMV for both the mother and infant
Antibody titer
Antibody titer is a laboratory test that measures the level of antibodies in a blood sample.
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Bilirubin level and blood tests for liver function
Bilirubin
The bilirubin blood test measures the level of bilirubin in the blood. Bilirubin is a yellowish pigment found in bile, a fluid made by the liver. Bi...
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CBC
CBC
A complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...
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CT scan or ultrasound of the head
CT scan
A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
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Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.
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Fundoscopy
Fundoscopy
Ophthalmoscopy is an examination of the back part of the eye (fundus), which includes the retina, optic disc, choroid, and blood vessels.
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TORCH screen
TORCH screen
The TORCH screen is a group of blood tests. These tests check for several different infections in a newborn. The full form of TORCH is toxoplasmosi...
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Urine culture for CMV virus in the first 2 to 3 weeks of life
Urine
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
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X-ray of the chest
X-ray of the chest
A chest x-ray is an x-ray of the chest, lungs, heart, large arteries, ribs, and diaphragm.
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Treatment
There is no specific treatment for congenital CMV. Treatments focus on specific problems, such as physical therapy and appropriate education for children with delayed physical movements.
Treatment with antiviral medicines is often used for infants with neurologic (nervous system) symptoms. This treatment may reduce hearing loss later in the child's life.
Outlook (Prognosis)
Most infants who have symptoms of their infection at birth will have neurologic abnormalities later in life. Most infants without symptoms at birth will NOT have these problems.
Some children may die while they are still an infant.
Possible Complications
Complications may include:
- Difficulty with physical activities and movement
- Vision problems or blindness
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Deafness
Deafness
Hearing loss is being partly or totally unable to hear sound in one or both ears.
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When to Contact a Medical Professional
Have your baby checked right away if a provider did not examine your baby shortly after birth, and you suspect your baby has:
- A small head
- Other symptoms of congenital CMV
If your baby has congenital CMV, it is important to follow your provider's recommendations for well-baby examinations. That way, any growth and development problems can be identified early and treated promptly.
Prevention
Cytomegalovirus is almost everywhere in the environment. The US Centers for Disease Control and Prevention (CDC) recommend the following steps to reduce the spread of CMV:
- Wash hands with soap and water after touching diapers or saliva.
- Avoid kissing children under the age of 6 on the mouth or cheek.
- Do not share food, drinks, or eating utensils with young children.
- Pregnant women working in a day care center should work with children older than age 2½.
References
Beckham JD, Solbrig MV, Tyler KL. Viral encephalitis and meningitis. In: Jankovic J, Mazziotta JC, Pomeroy SL, Newman NJ, eds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 78.
Britt WJ. Cytomegalovirus (CMV). In: Bennett JE, Dolin R, Blaser MJ, eds. Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 137.
Centers for Disease Control and Prevention website. Cytomegalovirus (CMV) and Congenital CMV Infection. www.cdc.gov/cmv/index.html. Updated August 18, 2020. Accessed June 18, 2023.
Huang FAS, Brady RC. Congenital and perinatal infections. In: Kliegman RM, St. Geme JW, Blum NJ, Shah SS, Tasker RC, Wilson KM, eds. Nelson Textbook of Pediatrics. 21st ed. Philadelphia, PA: Elsevier; 2020:chap 131.
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Congenital cytomegalovirus - illustration
Congenital cytomegalovirus is caused when an infected mother passes the virus to the fetus through the placenta. The infant is characteristically born with a rash, a large spleen or liver, jaundice, inflammation of the retina, and a small head.
Congenital cytomegalovirus
illustration
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Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
-
Congenital cytomegalovirus - illustration
Congenital cytomegalovirus is caused when an infected mother passes the virus to the fetus through the placenta. The infant is characteristically born with a rash, a large spleen or liver, jaundice, inflammation of the retina, and a small head.
Congenital cytomegalovirus
illustration
-
Antibodies - illustration
Antigens are large molecules (usually proteins) on the surface of cells, viruses, fungi, bacteria, and some non-living substances such as toxins, chemicals, drugs, and foreign particles. The immune system recognizes antigens and produces antibodies that destroy substances containing antigens.
Antibodies
illustration
Review Date: 4/28/2023
Reviewed By: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.