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Evaluation of 98 immunocompetent children with cytomegalovirus infection: importance of neurodevelopmental follow-up

Abstract

This study aims to analyze and evaluate the clinic and demographic features of immunocompetent children that have been diagnosed with cytomegalovirus (CMV) infection. The data of children diagnosed with CMV infection between January 2005 and December 2010 and their follow-ups for 2 years were retrospectively evaluated. Ninety-eight patients were included, and the median age at admission was 5.6 months (5 days–36 months). 54.1 % was male. The diagnosis of CMV infection was performed by measurement of serum anti-CMV specific Ig M and IgG titers and PCR method in blood and/or urine. In 3.06 % of the patients, congenital infection was detected, whereas possible congenital infection was observed in 36.7 % of the patients. Furthermore, 44 patients (44.8 %) were detected to have perinatal infection while postnatal infection was spotted in 15.3 % of the patients. The common presenting manifestations were prolonged jaundice, diarrhea, vomiting, abdominal distension, skin eruption, and seizure. And the most common physical examination findings were hepatosplenomegaly, microcephaly, jaundice, and petechia. The mainstream laboratory results were elevated transaminases (50 %), anemia (30.6 %), leukocytosis (27.5 %), and thrombocytopenia (18.3 %). There were intracranial calcification in 5.1 % and eye findings in 5.1 %. On follow-up of patients, complete improvement (59.1 %), neuromotor developmental delay (11.2 %), epilepsy (10.2 %), hearing loss (3.06 %), hemolytic anemia (2.04 %), and growth retardation (1.02 %) were detected.

Conclusion: CMV infection is a significant disease both in congenital and perinatal period. It must be considered that diagnosed patients need to be monitored for a long time with special attention to their neurodevelopmental follow-ups.

What is Known:
Manifestations, follow-up findings, and treatment approaches of CMV infection in immunocompetent individuals have not been extensively revised and have received less attention in the literature.
What is New:
This study is intended for evaluation of the clinical and demographic characteristics and laboratory findings of immunocompetent children with CMV infection in with a broad series of patients.

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Abbreviations

ALT:

Alanine aminotransferase

AST:

Aspartate aminotransferase

CMV:

Cytomegalovirus

CNS:

Central nervous system

CT:

Computed tomography

DNA:

Deoxyribonucleic acid

GGT:

Gamma-glutamyl transferase

MRI:

Magnetic resonance imaging

PCR:

Polymerase chain reaction

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Acknowledgments

All authors of this article contributed to gathering, analysis and writing of the information.

Author information

Correspondence to Saliha Kanik-Yuksek.

Additional information

Communicated by David Nadal

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Cite this article

Çelikel, E., Tezer, H., Kanik-Yuksek, S. et al. Evaluation of 98 immunocompetent children with cytomegalovirus infection: importance of neurodevelopmental follow-up. Eur J Pediatr 174, 1101–1107 (2015). https://doi.org/10.1007/s00431-015-2513-9

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Keywords

  • Cytomegalovirus infection
  • Children
  • Immunocompetent