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Congenital and perinatal cytomegalovirus lung infection

Eleonora Coclite1, Cecilia Di Natale, Giovanni Nigro

  • 1Pediatric Unit and School of the University of L'Aquila, Maternal-Infant Department of San Salvatore Hospital , L'Aquila , Italy.

The Journal of Maternal-Fetal & Neonatal Medicine : the Official Journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians
|April 11, 2013
PubMed

Insights

Cytomegalovirus (CMV) infection can cause severe lung disease in infants, particularly premature ones. Antiviral therapy

Area of Science:

  • Neonatalogy
  • Pediatric Pulmonology
  • Infectious Diseases

Background:

  • Cytomegalovirus (CMV) pneumonitis poses a significant threat, potentially leading to severe or fatal outcomes in infants with congenital or perinatal infections.
  • Premature infants are particularly vulnerable to severe CMV lung disease.

Purpose of the Study:

  • To comprehensively review the epidemiology, pathogenesis, clinical manifestations, and therapeutic strategies for prenatal and perinatal CMV-induced lung diseases in infants.
  • To synthesize current knowledge on CMV pneumonitis in neonates.

Main Methods:

  • Systematic evaluation of all published research articles on PubMed concerning CMV pneumonitis in infants.
  • Literature review focusing on epidemiological, pathogenetic, clinical, and therapeutic aspects.

Main Results:

  • CMV infection is prevalent and severe in immunosuppressed infants, less common in full-term neonates, and more frequent post-perinatal transmission, especially in premature infants.
  • In premature infants, CMV infection often results in prolonged illness, diffuse interstitial pneumonitis, fibrosis, and bronchopulmonary dysplasia (BPD).
  • Congenital CMV infection should be considered in neonates with severe respiratory distress, refractory respiratory failure, and progressing chronic lung disease; breast milk transmission is linked to cystic lung disease.

Conclusions:

  • Persistent CMV infection can lead to diffuse necrotizing pneumonitis with fibrosis, ultimately causing BPD in both immunocompromised/preterm and, less commonly, immunocompetent infants.
  • The efficacy of antiviral therapy for infant respiratory CMV diseases requires further investigation, as current data are limited to anecdotal reports.
Abstract

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