Konopka Wiesław, Śmiechura-Gańczarczyk Małgorzata, Pepaś Renata
Department of Otolaryngology, Polish Mother's Memorial Hospital-Research Institute, Lodz, Poland.
Prz Menopauzalny. 2021 Sep;20(3):122-126. doi: 10.5114/pm.2021.109391. Epub 2021 Sep 24.
One per cent of live births are affected by cytomegalovirus infection, but 90% of neonates with perinatal infection do not show symptoms of disease. Symptomatic cytomegalovirus (CMV) is present in 5-10% of children. Typical clinical signs of congenital cytomegalovirus infection are microcephalia, mental retardation, progressive major amblyacousia, and neuromuscular infection. Hypoacusis is present in 30-60% of children with congenital symptomatic CMV - in most cases it is bilateral and applies to high-frequency hearing loss.
A group of 70 children had serological and genetic screening of viral DNA using the polymerase chain reaction method in urine and blood. In this group, 52 children were diagnosed with congenital CMV, and 10 children were diagnosed with acquired CMV. Audiological examinations including pure-tone audiometry, auditory brainstem response, transiently evoked otoacoustic emission, and immittance audiometry were performed.
Bilateral sensorineural hearing loss was in 9 children associated with mental and physical retardation, brain malformation, and microcephalia. Unilateral hearing loss was observed in 3 children. In 40 cases, we did not observe hearing loss, although the level of bilirubin was high, as well as splenomegaly, hepatomegaly, and facial nerve paralysis.
Congenital cytomegalovirus infection often caused hearing loss. Children with congenital and acquired CMV should be under the permanent care of an audiologist. The growing problem of CMV infections and their late diagnosis suggests the need to prepare screening tests and increase the education of gynaecologists, neonatologists, paediatricians, and general practice doctors about CMV problems.
1%的活产儿受巨细胞病毒感染影响,但90%的围产期感染新生儿未表现出疾病症状。有症状的巨细胞病毒(CMV)感染在5% - 10%的儿童中存在。先天性巨细胞病毒感染的典型临床体征是小头畸形、智力发育迟缓、进行性重度弱视和神经肌肉感染。30% - 60%的先天性有症状CMV感染儿童存在听力减退——在大多数情况下为双侧性,且为高频听力损失。
一组70名儿童采用聚合酶链反应法对尿液和血液中的病毒DNA进行了血清学和基因筛查。该组中,52名儿童被诊断为先天性CMV感染,10名儿童被诊断为获得性CMV感染。进行了包括纯音听力测定、听性脑干反应、瞬态诱发耳声发射和声导抗测听在内的听力学检查。
9名儿童出现双侧感音神经性听力损失,伴有智力和身体发育迟缓、脑畸形和小头畸形。3名儿童观察到单侧听力损失。在40例病例中,尽管胆红素水平高,且存在脾肿大、肝肿大和面神经麻痹,但未观察到听力损失。
先天性巨细胞病毒感染常导致听力损失。先天性和获得性CMV感染儿童应长期接受听力学家的护理。CMV感染问题日益严重及其诊断延迟表明,需要准备筛查测试,并加强对妇科医生、新生儿科医生、儿科医生和全科医生进行关于CMV问题的教育。