Tzialla Chryssoula, Salomè Serena, Mondì Vito
Neonatal and Pediatric Unit, Polo Ospedaliero Oltrepò, ASST Pavia, 27058 Voghera, Italy.
Division of Neonatology, Department of Translational Medical Sciences, University of Naples Federico II, 80138 Naples, Italy.
Microorganisms. 2025 Mar 28;13(4):772. doi: 10.3390/microorganisms13040772.
Cytomegalovirus (CMV), the largest of the herpes viruses, is a widespread virus that commonly infects people of all ages. CMV can cause a spectrum of clinical manifestations, ranging from asymptomatic infection to severe disease, particularly in immunocompromised hosts. However, postnatal and acquired CMV infections in immunocompetent children remain under-documented in the literature. In this review, we examine studies published over the past decade to explore the clinical manifestations of CMV infections in the pediatric population, focusing on the variety of symptoms and the severity with which the infection can present. Papers published between 1 January 2014 and 2 December 2024 were selected from PubMed/MEDLINE, Embase, Scopus, and Web of Science. The search was conducted using the following keywords: "cytomegalovirus", "child", and "immunocompetent". The target population ranged from 0 to 17 years of age, with congenital and perinatal infections excluded. Despite the clinical significance of CMV in immunocompetent infants and children, there is a lack of consensus on the use and duration of antiviral therapy. This article aims to enhance clinicians' understanding of the various presentations of CMV infection in immunocompetent children, with the goal of facilitating earlier diagnosis and appropriate management. The reviewed papers indicated that postnatal CMV results in liver symptoms in 67% of cases, followed by hematological disorders and gastrointestinal pathology. In older children, primary infection leads to liver disease in 51% of cases, with greater neurological and pulmonary involvement compared to that in infants. By highlighting the wide-ranging clinical effects of CMV, we hope to improve physicians' ability to recognize and subsequently treat this often overlooked condition in pediatric patients.
巨细胞病毒（CMV）是疱疹病毒中最大的一种，是一种广泛传播的病毒，通常感染各个年龄段的人群。CMV可引起一系列临床表现，从无症状感染到严重疾病，尤其是在免疫功能低下的宿主中。然而，免疫功能正常儿童的产后和获得性CMV感染在文献中的记录仍然不足。在本综述中，我们研究了过去十年发表的研究，以探讨CMV感染在儿科人群中的临床表现，重点关注各种症状以及感染可能呈现的严重程度。从PubMed/MEDLINE、Embase、Scopus和Web of Science中选取了2014年1月1日至2024年12月2日发表的论文。搜索使用了以下关键词：“巨细胞病毒”、“儿童”和“免疫功能正常”。目标人群为0至17岁，排除先天性和围产期感染。尽管CMV在免疫功能正常的婴幼儿中具有临床意义，但在抗病毒治疗的使用和持续时间上缺乏共识。本文旨在增强临床医生对免疫功能正常儿童CMV感染各种表现的理解，以促进早期诊断和适当管理。综述论文表明，产后CMV感染在67%的病例中导致肝脏症状，其次是血液系统疾病和胃肠道病变。在年龄较大的儿童中，原发性感染在51%的病例中导致肝脏疾病，与婴儿相比，神经系统和肺部受累更为严重。通过强调CMV广泛的临床影响，我们希望提高医生识别并随后治疗儿科患者中这种常被忽视疾病的能力。
