Congenital cytomegalovirus

Elena Grebenciucova MD (Dr. Grebenciucova of the University of Chicago has no relevant financial relationships to disclose.)
Raymond P Roos MD (Dr. Roos of the University of Chicago owns stock in Amgen, Best Doctors, Express Scripts, Ionis, and Merck.)
Originally released November 1, 1993; last updated February 20, 2017; expires February 20, 2020

This article includes discussion of congenital cytomegalovirus, intrauterine cytomegalovirus infection, prenatal cytomegalovirus, and cytomegalic inclusion disease. The foregoing terms may include synonyms, similar disorders, variations in usage, and abbreviations.

Overview

Cytomegalovirus (CMV) is a ubiquitous agent responsible for most intrauterine infections. Besides well-known symptoms and findings such as hearing loss and microcephaly, congenital cytomegalovirus infection can also underlie certain cerebral anomalies and static leukodystrophies. In this article, the authors discuss uncommon presentations of asymptomatic congenital cytomegalovirus, predicted outcomes of congenital multi-strain cytomegalovirus infection, and updates on potential cytomegalovirus vaccines.

Key points

 

• Cytomegalovirus is the most common infection of the developing brain.

 

• Congenital cytomegalovirus infection can cause a host of cerebral abnormalities, including calcifications, ventriculomegaly, white matter lesions, cortical atrophy, and cortical migration abnormalities.

 

• Affected children can have neurologic impairments that range from sensorineural hearing loss to profound mental and motor deficits.

Historical note and terminology

In 1904, Ribbert described a stillborn infant with congenital syphilis who had large inclusion-bearing cells in the kidney (Ribbert 1904). A similar report followed (Jesionek and Kiolemenoglou 1904). These are probably the first cases of congenital cytomegalovirus described in literature. By 1921, it was postulated that the inclusions were due to an infectious agent, most likely a virus (Goodpasture and Talbot 1921; Lipschutz 1921). The agent was subsequently called "salivary gland virus," and the infection was referred to as "cytomegalic inclusion disease.” Murine cytomegalovirus was successfully grown in tissue culture in 1954 (Smith 1954). Two years later, human cytomegalovirus was isolated from congenitally infected children using similar techniques (Smith 1956; Weller et al 1957). The name "cytomegalovirus" was accepted in 1960 (Weller et al 1960).

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