Institut für Medizinische Virologie, Klinikum der J W Goethe-Universität, Paul Ehrlich Str. 40, D-60596, Frankfurt am Main, Germany.
J Clin Virol. 2011 Aug;51(4):285-8. doi: 10.1016/j.jcv.2011.05.007.
Human cytomegalovirus (CMV) is considered as the most common cause of congenital infection in humans and the overall burden for the public health system is rather high. About 1/10 of vertically infected newborns present or develop severe signs of cytomegalic inclusion disease (CID), with the classical triad of chorioretinitis, microcephaly and cerebral calcifications. However the most symptomatic cases are detected postnatal and methods of diagnostic virology raised the questions for the gold standard in laboratory screening. The current problems in diagnosis and therapy are outlined in two different cases: An acute primary CMV infection with no clinical signs of illness in both mother and child and a secondary CMV-infection resulting in necrotizing CMV encephalitis in the fetus. Beside virus detection in whole blood samples and other fluids, newly adopted laboratory assays like the destination of CMV-IgG avidity were necessary. Furthermore a serologic screening for pregnant women should be implicated routinely. Passive IgG treatment of the mother was helpful but the ultimate goal in prevention of congenital CMV infection is to develop a vaccine, which would be administered to seronegative women.
人巨细胞病毒（CMV）被认为是人类先天性感染的最常见原因，对公共卫生系统的整体负担相当高。约有 1/10 的垂直感染新生儿出现或发展为巨细胞包涵体病（CID）的严重症状，具有脉络膜视网膜炎、小头畸形和脑钙化的经典三联征。然而，最具症状的病例是在产后发现的，病毒诊断方法提出了实验室筛查的金标准问题。在两个不同的病例中概述了诊断和治疗的当前问题：母亲和孩子均无临床疾病迹象的急性原发性 CMV 感染，以及继发 CMV 感染导致胎儿坏死性 CMV 脑炎。除了在全血样本和其他体液中检测病毒外，还需要采用新采用的实验室检测方法，如 CMV-IgG 亲和力的目标。此外，应常规对孕妇进行血清学筛查。母亲的被动 IgG 治疗是有帮助的，但预防先天性 CMV 感染的最终目标是开发疫苗，将其施用于血清阴性的女性。
