Congenital cytomegalovirus Infection: a case report

Gancyclovir and valgancyclovir treatment in congenital CMV infection with central nervous system involvement is controversial. A term neonate delivered via vaginal route was found to have dysmorphic facies and a palpable liver extending 3 cm below intercostal margin. The detection of enlargement of subarachnoid space, ventricular dilatation and periventricular calcification in cranial computerized tomography suggested congenital CMV infection. Serologic tests of the patient revealed that CMV IgM was positive. The mother’s serology was found to be CMV IgG(+) and CMV IgM(-). Chorioretinitis was not found in ophtalmological examination. Brain stem evoked potentials and audiometric evaluation were found to be normal. After detection of CMV DNA positivity in PCR, gancyclovir treatment was continued for 6 weeks. Multisystemic involvement in congenital CMV infection should be suspected and in case of central nervous system involvement, medical treatment should be initiated.

Konjenital sitomegalovirus enfeksiyonu

Santral sinir sistemini tutulumu olan konjenital CMV enfeksiyonu tedavisinde Gansiklovir tedavisi tartýþmalýdýr. Zamanýnda spontan doðumla doðan olgunun annesinde CMV IgG (+), CMV IgM (-) saptandýðý öðrenildi. Olgunun fizik muayenesinde dismorfik yüz görünümü ve 3 cm hepatomegali tespit edildi. Kraniyal tomografisinde subaraknoid mesafede geniþlik ventrikül dilatasyonu, periventriküler kalsifikasyon saptanmasý nedeniyle olguda konjenital CMV enfeksiyonu düþünüldü. Olgunun serolojik testlerinde CMV IgM (+) saptandý. Koryoretinit tespit edilmedi. Beyin sapý iþitsel uyarýlmýþ potansiyeller ve odyometrisi normal saptandý. Plazma CMV DNA PCR pozitif saptanan olguya Gansiklovir tedavisi 6 hafta olarak devam edildi. Konjenital CMV enfeksiyonunda multisistem tutulumu olabileceði öngörülmeli ve santral sinir sistemi tutulumunda medikal tedavi baþlanmalýdýr.