[Cytomegalovirus and acquired congenital deafness]

Cytomegalovirus (CMV) is nowadays a frequent causal agent in pediatric acquired hearing loss and should become the principal one in the next few years. CMV is a herpes like virus. Eighty percent of all adults are carriers of this virus in the salivary glands, without any symptom. In the pregnant women, CMV can act by reactivation and give a placental and foetal infection. The pregnant woman is generally asymptomatic when infected. In the infant, besides death in utero, the CMV can produce two clinical types. Ten percent of the congenitally infected infants presented symptoms at birth. In a quarter of them the clinical picture is a severe ictero-hemorrhagic syndrome with infaust prognosis. Most often the clinical picture is an incomplete syndrome with serious neurological, hepatic, developmental, ophthalmic and auditory sequelae. The subclinical form represents 90% of the infected infants. Normal at birth, about 20% of these develop hypoacusis. During the antenatal period, a rise in titre in serologic examination signals a reactivation of the virus. At birth, the diagnosis is by cytodiagnosis and the identification of specific foetal CMV antibodies. The postnatal diagnosis--the most frequent for the otolaryngologist--is based on the concommitant raised titers in both mother and child and/or the presence of other neurological or ophthalmic signs by the child. The prevention is practically impossible. Many medical treatments are studied and nowadays the follow up of a high risk group seems to remain the best attitude.