engleski

Head circumference dynamics in congenital cytomegalovirus infection

Congenital cytomegalovirus (CMV) infection is the most common cause of severe and mild neurological disorders affecting approximately 1% of live births. CMV can affect all neurogenetic processes during the brain development and therefore disturbed dynamics of postnatal brain growth may occur. Microcephaly, as one of the most prominent clinical findings, is important predictor of mental retardation, behavioral problems and cerebral palsy. We present brain growth dynamics by measuring head circumference (HC) in 15 children with congenital CMV infection. They were all symptomatic at birth and/or during the early postnatal neurodevelopment, presenting with intrauterine growth restriction, microcephaly, hypotonia, impaired hearing, intracranial calcifications and optic nerve atrophy as well as the gastroenterological disorders (prolonged vomiting, failure to thrive and neonatal hepatitis). CMV infection was confirmed postnatally in all patients by polymerase chain reaction (PCR) of CMV DNA, immunoassay on CMV-specific IgM and IgG antibodies. Head circumference measurements were performed with flexible metal centimeter occipitofrontally during the neurodevelopmental follow-up schedule. Data on head circumference input was verified according to Nellhaus head circumference percentile curves with gender and age corrections. Out of 15 patients presented, 9 were treated by specific antiviral therapy (gancyclovire). During follow-up 5 out of 15 had microcephaly i.e. HC < 2 percentile, while remaining 10 patients had HC < 50 percentile.

cytomegalovirus; microcephaly; head circumference; mental retardation; cerebral palsy; impaired hearing; intracranial calcifications

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