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从诊断到管理:先天性巨细胞病毒感染的当前观点。

From diagnosis to management: current perspectives on congenital cytomegalovirus infection.

机构信息

Department of Pediatrics.

Department of Microbiology, University of Alabama at Birmingham, Heersink School of Medicine, Birmingham, Alabama, USA.

出版信息

Curr Opin Infect Dis. 2024 Aug 1;37(4):232-237. doi: 10.1097/QCO.0000000000001023. Epub 2024 May 14.

Abstract

PURPOSE OF REVIEW

Congenital CMV (cCMV) infection is the most common infection of newborns and a leading cause of hearing loss and other neurologic disabilities in children. This review focuses on the diagnosis, presentation and management of cCMV infection.

RECENT FINDINGS

Cytomegalovirus is one of the leading causes of sensorineural hearing loss in children. It also leads to neurodevelopmental disabilities and learning problems throughout childhood in both symptomatic and asymptomatic newborns. Urine and saliva PCR testing are the preferred methods of testing newborn infants for cCMV. In recent years, newborn-targeted and universal screening programs have been implemented in several states and major medical centers with the goal of identifying infected infants at risk for hearing loss. Treatment for infants diagnosed with cCMV infection should be limited to those who are moderately to severely symptomatic at birth with cCMV infection, though treatment may be beneficial for children who are asymptomatic with isolated sensorineural hearing loss.

SUMMARY

As more children with cCMV are being identified through newborn screening, understanding the clinical presentation and sequelae is important for appropriate management of children with cCMV.

摘要

目的综述

先天性巨细胞病毒(cCMV)感染是新生儿最常见的感染,也是儿童听力损失和其他神经发育障碍的主要原因。本综述重点介绍 cCMV 感染的诊断、表现和管理。

最新发现

巨细胞病毒是儿童感音神经性听力损失的主要原因之一。它还会导致有症状和无症状新生儿在整个儿童期出现神经发育障碍和学习问题。尿和唾液 PCR 检测是检测新生儿 cCMV 的首选方法。近年来,一些州和主要医疗中心实施了针对新生儿的和普遍的筛查计划,目的是识别有听力损失风险的感染婴儿。对于出生时患有 cCMV 感染且有中度至重度症状的婴儿,应限制使用治疗方法,但对于无症状且仅有孤立性感音神经性听力损失的儿童,治疗可能有益。

总结

随着通过新生儿筛查发现越来越多的 cCMV 患儿,了解其临床表现和后遗症对于 cCMV 患儿的适当管理非常重要。

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