Congenital Cytomegalovirus Infection - Lessons from a Clinical Case

Abstract

Background : Cytomegalovirus (CMV) is a worldwide spread herpes virus that establishes a latent infection after the primary infection. It becomes a major problem in immunocompromised patients and in cases of primary or reactivated infection during pregnancy. CMV is the most common congenital infection and is the leading infectious cause of sensoneural deafness and cerebral mental retardation. Aim : Тo raise the attention to the discordance in our knowledge of cCMV infection and the implementation of the knowledge in practice. Materials and methods : CMV-DNA was extracted from saliva and plasma samples according to the protocol of DNA-Sorb-A, Sacace, Biotechnologies, Italy. Polymerase chain reaction (PCR) was performed using a commercial kit based on the Taq-man principle: Quantitative RT-PCR for CMV-DNA detection (Sacace, Biotechnologies, Italy). The linear range of the CMV Real-TM Quant PCR test is 500-10000000 copies/ml, and the reported sensitivity is 400 copies/ml. Results : The infant was born with clinical manifestations involving development of hepatosplenomegaly, chorioretinitis, anemia, microcephaly and simultaneous dilatation of the brain ventricles. CMV infection was confirmed using modern PCR studies. Conclusions : This case highlights the need for specific virological/PCR tests to be performed for all children with the least suspected congenital infection, especially when there is an option of a specific treatment.