Clinical features

Att birth

• roughly 90% of neonates with cCMV (congenital cytomegalovirus) have no overt signs of infection
  
  
• of the 10% who are symptomatic, most have a combination of one or more findings
  • classical signs of cCMV in neonates include:
    • small for gestational age,
    • microcephaly,
    • jaundice,
    • hepatosplenomegaly,
    • petechial rash,
    • seizures, or
    • intracranial abnormalities (eg, calcifications)
    • sensorineural hearing loss (SNHL) (unilateral or bilateral) is also common
      
      

Neonates with no overt symptoms may be diagnosed through systematic neonatal screening or retrospectively after sensorineural hearing loss is diagnosed later in childhood

Possible clinical concerns:

• 1 month to 1 year old
  • possible clinical concerns
    • feeding difficulties, seizures, SNHL, chorioretinitis, developmental delays, sleep difficulties
  • possible examination findings
    • persistent low tone or developing spasticity, low core strength, microcephaly, persistent hepatosplenomegaly
• 1 - 6 years old
  • possible clinical concerns
    • feeding difficulties, seizures/epilepsy, SNHL, vision loss, developmental delay, learning difficulties, sleep difficulties, behaviour problems, balance problems, mobility needs
  • possible examination findings
    • persistent low tone or developing spasticity, restricted range of motion from spasticity, low core strength
• 6- 18 years old
  • possible clinical concerns
    • feeding difficulties, seizures/epilepsy, SNHL, vision loss, developmental delay, learning difficulties, sleep difficulties, behaviour problems,
      balance problems, mobility needs, increasing independence in self-care
  • possible examination findings
    • persistent low tone or developing spasticity, restricted range of motion from spasticity, low core strength

Reference:

1. Pesch MH et al. Congenital cytomegalovirus infection.BMJ 2021;373:n1212 | doi: 10.1136/bmj.n1212