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先天性巨细胞病毒感染的诊断与管理。

Congenital cytomegalovirus infection diagnostics and management.

机构信息

Assistant Professor of Pediatrics, Pediatric Infectious Diseases, Heersink School of Medicine I University of Alabama at Birmingham.

Hugh Dillon MD Endowed Professor in Pediatric Infectious Diseases, Professor of Pediatrics and Microbiology, Heersink School of Medicine I University of Alabama at Birmingham, Birmingham, Alabama, USA.

出版信息

Curr Opin Infect Dis. 2022 Oct 1;35(5):436-441. doi: 10.1097/QCO.0000000000000874. Epub 2022 Aug 19.

Abstract

PURPOSE OF THE REVIEW

Congenital cytomegalovirus infection (cCMV) is the most frequent congenital infection and a leading nongenetic cause of sensorineural hearing loss (SNHL) and brain disease. The purpose of this review is to highlight recent developments in the diagnosis and management of children with cCMV.

RECENT FINDINGS

Progress is being made in the efforts to identify more infants with cCMV, especially those with asymptomatic infection. Largely due to efforts by various advocacy/parent groups, a number of states in the United States and many hospital systems have implemented hearing targeted CMV screening and mandated education of pregnant women about CMV.

SUMMARY

cCMV is an important cause of SNHL and neurologic morbidity worldwide. Early identification of infected children is critical to improve outcomes by providing timely interventions and guidance for long-term follow up. The fact that most infants with cCMV have no abnormal clinical findings, and the need to obtain samples for diagnosis within the first 2-3 weeks of life, makes it challenging to identify a majority of infants with cCMV without universal newborn CMV screening.

摘要

目的综述

先天性巨细胞病毒感染(cCMV)是最常见的先天性感染,也是导致感音神经性听力损失(SNHL)和脑部疾病的主要非遗传原因。本文旨在强调先天性巨细胞病毒感染儿童的诊断和管理方面的最新进展。

最新发现

目前正在努力识别更多的 cCMV 感染婴儿,尤其是无症状感染的婴儿。由于各种宣传/家长团体的努力,美国的许多州和许多医院系统已经实施了针对听力的 CMV 筛查,并要求对孕妇进行 CMV 教育。

总结

cCMV 是全球 SNHL 和神经发育障碍的重要原因。早期发现感染儿童对于通过及时干预和长期随访指导来改善结局至关重要。事实上,大多数 cCMV 感染婴儿没有异常的临床发现,并且需要在生命的前 2-3 周内获得样本进行诊断,因此,如果没有普遍的新生儿 CMV 筛查,识别大多数 cCMV 感染婴儿具有挑战性。

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