Clinical findings and adverse outcome in neonates with symptomatic congenital cytomegalovirus (SCCMV) infection
Clinical findings and adverse outcome in neonates with symptomatic congenital cytomegalovirus (SCCMV) infection
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DOI：
10.1007/s00431-006-0172-6
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发表时间：
2006-11-01
影响因子：
3.6
通讯作者：
Ford-Jones, Elizabeth Lee
中科院分区：
文献类型：
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作者：
Kylat, Ranjit I.;Kelly, Edmond N.;Ford-Jones, Elizabeth Lee
先天性巨细胞病毒（CCMV）感染是一种常见的新生儿感染，影响所有活产婴儿的1%，其中10%有症状。这些婴儿中有许多有长期的后遗症。目的是记录新生儿SCCMV感染的临床表现，后遗症的频率和不良神经系统结局的严重程度以及危险因素。方法对所有诊断为SCCMV感染的有症状婴儿进行回顾性分析。SCCMV被定义为在生命的前三周出现任何临床表现时诊断为CCMV感染。分析2岁及以后的结局数据。结果确诊SCCMV感染104例，确诊感染42例。常见表现为肝脾肿大19/42(45%)，血小板减少21/42(50%)，转氨酶升高21/42(50%)，颅脑US扫描异常24/41(56%)，头部CT扫描异常29/41(71%)，脑MRI异常17/19（89%）。不良结果的危险因素包括死亡、耳聋或失明或中度至重度神经功能缺损，包括颅US扫描异常（or 8.5）、头部CT扫描异常（or 21）和脑干听觉诱发反应异常（BAER） （or 8.7）。结论：只有3例（7%）无任何缺陷的患者和严重感染的婴儿被确定为不同的临床表现，这加强了巨细胞病毒作为一个主要公共卫生问题的重要性。
Introduction Congenital cytomegalovirus (CCMV) infection is a common neonatal infection affecting 1% of all live births, 10% of which are symptomatic. Many of these infants have long-term sequelae. The objective is to document the clinical presentation of SCCMV infection in neonates, the frequency of sequelae and severity of adverse neurologic outcomes and risk factors.Methods A review and analysis of all symptomatic infants diagnosed with SCCMV infection are given. SCCMV was defined as a diagnosis of CCMV infection in the first three weeks of life in the presence of any clinical manifestations. Outcome data from 2 years of age and later are analyzed.Results There were 104 patients identified as having SCCMV infection and of these 42 cases had definite infection. The common findings at presentation were hepatosplenomegaly 19/42 (45%), thrombocytopenia 21/42 (50%), elevated transaminases 21/42(50%), abnormal cranial US scan 24/41(56%), abnormal head CT scan 29/41(71%) and abnormal brain MRI 17/19(89%). The risk factors for an adverse outcome including death or deafness or blindness or moderate to severe neurological deficits included an abnormal cranial US scan (OR 8.5), abnormal head CT scan (OR 21) and abnormal brainstem auditory evoked responses (BAER) (OR 8.7).Conclusions There was only three (7%) patients without any deficits and severely affected infants have been identified with a diverse clinical presentation, reinforcing the importance of CMV as a major public health problem.