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Archives de pédiatrie
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le dimanche 1 mars 2020
Doi : 10.1016/j.arcped.2020.01.006
Received : 28 August 2019 ;  accepted : 25 January 2020
Outcome and management of newborns with congenital cytomegalovirus infection
 

M. Nicloux a, L. Peterman a, M. Parodi b, J.-F. Magny a,
a Service de réanimation néonatale, CHU Necker-Enfants malades, 149, rue de Sèvres, 75015 Paris, France 
b Service d’ORL, CHU Necker-Enfants malades, 75015 Paris, France 

Corresponding author.
Abstract

Congenital cytomegalovirus (CMV) infection is the most common non-genetic cause of hearing loss and neurological disorder in children. Its overall prevalence is approximately 0.5% in Europe. In France, systematic screening during pregnancy is not recommended; screening is performed only if there are maternal or fetal symptoms suggestive of this infection. Approximately 90% of infected newborns are asymptomatic at birth, and among them the risk of neurosensory sequelae is 5–15%. By contrast, the prevalence of neurosensory impairment in symptomatic newborns at birth varies from 17% to 60%. Congenital CMV infection must be confirmed at birth before the 21st day of life by polymerase chain reaction (PCR) on saliva or urine samples. A complete clinical examination, blood tests (blood count, liver function test, CMV PCR), hearing tests, brain ultrasound and eye fundus examination should be performed. Neurological and auditory follow-up must be extended well beyond the neonatal period because the occurrence of neurosensory sequelae may be delayed. Oral valganciclovir is the recommended treatment in moderate or severe congenital CMV infections for a period of 6 weeks to 6 months; such treatment requires regular monitoring because of its possible side effects.

The full text of this article is available in PDF format.

Keywords : Congenital cytomegalovirus infection, Predictors of sequelae, Hearing loss, Neurological sequelae, Extended follow-up




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