Cytomegalic inclusion disease of the newborn- A short review

CMV infection is common in all populations but rarely associated with symptomatic illness in immunocompetent individuals. Immunocompromised patients are more commonly affected and it is a major cause of multi-organ dysfunction. The severity of disease depends upon degree of immunosuppression. Infection with CMV is extremely common but disease is a rare occurrence. The large majority of infections are clinically in apparent as with other Herpes virus infections, leading to prolonged latency, with occasional reactivation. Intrauterine or postnatal infections may lead to the development of clinical disease. Cytomegalic inclusion disease is seen almost exclusively in infants born to mothers developing primary CMV infection during pregnancy. Cytomegalic inclusion disease of the newborn or fetal death are common sequelae of Intrauterine CMV infections. This is associated with hepatosplenomegaly, jaundice, thrombocytopenic purpura and hemolytic anemia. The cytomegalic inclusion disease is probably the most important cause of microcephaly. Other manifestations are chorioretinitis and cerebral calcification. Survivors may show mental retardation. The diagnosis of CMV relies on demonstration of the agent (virus, viral proteins and nucleic acids) either in body fluids, and/or tissue or on serological responses in a patient with clinical findings consistent with CMV infection. Antivirals for systemic treatment of congenital and perinatal CMV infection are ganciclovir and valganciclovir. High-risk group such as patients undergoing allogenic bone marrow organ transplantation, acquired or innate immunodeficiency syndromes and premature infants are ideal candidates for prophylaxis against CMV infection. Administration of CMV immunoglobulins and screening of blood and organ donors for virus and its products are considered in prevention.