Verboon-Maciolek M A, Gerards L J, Stoutenbeek P, van Loon A M
Universitair Medisch Centrum/Wilhelmina Kinderziekenhuis, Postbus 85.090, 3508 AB Utrecht.
Ned Tijdschr Geneeskd. 2001 Jan 27;145(4):153-6.
In 2 infants, a girl and a boy, congenital viral infection was diagnosed in the neonatal period. The prenatal examination (serologic investigation for Toxoplasma gondii, rubella virus, cytomegalovirus, herpes simplex virus and syphilis (TORCHES)) was negative. In both cases prenatal ultrasonography was abnormal and suggested intrauterine infection. The infants were born with typical symptoms of multisystem disease, known as symptomatic congenital cytomegalovirus infection (jaundice, petechiae, hepatosplenomegaly, intrauterine growth retardation, microcephaly and cerebral calcifications) and congenital rubella syndrome (intrauterine growth retardation, congenital heart disease, cataract, hepatosplenomegaly and cerebral calcifications), respectively. Both had severe cerebral damage. To diagnose severe congenital infection in the first trimester of pregnancy in presence of congenital anomalies in utero there are other possible methods than TORCHES investigation, such as polymerase chain reaction and virus culture in amniotic fluid or in foetal blood obtained by cord puncture.
在2名婴儿(1名女孩和1名男孩)中,新生儿期诊断出先天性病毒感染。产前检查(弓形虫、风疹病毒、巨细胞病毒、单纯疱疹病毒和梅毒的血清学调查(TORCHES))呈阴性。在这两例病例中,产前超声检查均异常,并提示宫内感染。这两名婴儿出生时均有典型的多系统疾病症状,分别为有症状的先天性巨细胞病毒感染(黄疸、瘀点、肝脾肿大、宫内生长迟缓、小头畸形和脑钙化)和先天性风疹综合征(宫内生长迟缓、先天性心脏病、白内障、肝脾肿大和脑钙化)。两人均有严重的脑损伤。对于孕期前三个月在子宫内存在先天性异常的情况下诊断严重先天性感染,除了TORCHES检查外,还有其他可能的方法,如羊水或通过脐带穿刺获得的胎儿血液中的聚合酶链反应和病毒培养。