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Use of In vivo Imaging to Monitor the Progression of Experimental Mouse Cytomegalovirus Infection in Neonates
Published on: July 6, 2013
Retrospectively diagnosing congenital cytomegalovirus infections in symptomatic infants is challenging
Natalia Lüsebrink1, Matthias Kieslich1, Holger F Rabenau2
1Department of Neurology, Neurometabolics and Prevention, Clinic for Children and Adolescents, University Hospital Frankfurt/Main, Frankfurt/Main, Germany.
Insights
Diagnosing congenital cytomegalovirus (CMV) in infants was challenging. Many cases were excluded or unconfirmed due to incomplete workups or data destruction laws, impacting congenital CMV infection diagnosis.
Area of Science:
- Virology
- Pediatrics
- Infectious Diseases
Background:
- Congenital cytomegalovirus (CMV) infection is a significant cause of neurological symptoms in hospitalized infants.
- Accurate and timely diagnosis is crucial for appropriate management and outcomes.
Purpose of the Study:
- To analyze the diagnostic workup process for hospitalized infants suspected of having congenital CMV infections.
- To identify challenges and limitations in diagnosing congenital CMV in a clinical setting.
Main Methods:
- Retrospective study of 117 infants aged 4 weeks to 12 months with neurological symptoms suggestive of congenital CMV.
- Review of diagnostic workup data, including serology and polymerase chain reaction (PCR) on dried blood spots (DBS).
Main Results:
- Diagnostic workup data were available for 84% of infants; 54% were definitively excluded for CMV infection.
- 16% of cases had incomplete workups, and 30% had DBS requested, with CMV DNA detection confirming infection in 6 out of 29 infants.
- Congenital CMV infection was diagnosed in 5% and excluded in 62% of patients, with 33% remaining unanswered.
Conclusions:
- Congenital CMV infection was diagnosed in a small percentage of evaluated infants (5%).
- Diagnostic investigations were not consistently stringent, and German law regarding DBS destruction posed a challenge.
- The diagnostic workup for congenital CMV in hospitalized infants requires optimization to ensure accurate and complete diagnoses.
Aim:
Our aim was to analyse the diagnostic workup of hospitalised infants with symptoms of congenital cytomegalovirus (CMV) infections.
Methods:
This retrospective study was carried out at the University Hospital Frankfurt, Germany, from 2008 to 2017 on infants aged 4 weeks to 12 months presenting with neurological symptoms consistent with congenital CMV infections.
Results:
We studied 117 infants, and workup data for CMV infections were available for 84%. Of these, 54% were immunoglobulin G- and immunoglobulin M-seronegative for CMV or immunoglobulin G-seropositive with no viral shedding. Congenital CMV infection was excluded in these cases. In 16%, the CMV workup was incomplete, precluding a definitive diagnosis. Dried blood spots (DBS) were requested from 30%. CMV polymerase chain reaction was negative in 19 of these 29 infants, and CMV deoxyribonucleic acid detection confirmed congenital CMV infections in six patients. DBS had been destroyed in line with German law in four cases. Congenital CMV infections were diagnosed (5%) or excluded (62%) in 67% of patients and unanswered in the remaining 33%.
Conclusion:
Diagnoses of congenital CMV infections were widely considered and found in 5%. CMV was not stringently investigated in all patients or remained elusive due to German law on destroying DBS.
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