treatment with a six month course of valganciclovir starting in the first month of life has been associated with improved hearing and developmental outcomes at 24 months (1)
owing to the risk of associated toxicities, particularly neutropenia, expert guidance recommend valganciclovir treatment for infants with symptomatic disease and those with isolated sensorineural hearing loss, but not for asymptomatic infants
infants should be monitored for toxicities by a paediatric infectious disease specialist throughout the treatment course
hearing surveillance
serial audiological evaluations
starting at baseline and continuing every 3-6 months until 3 years, and then annually until 6 years - are recommended because of the high risk of hearing deterioration in this period.
others recommend continuing routine audiological evaluations through adolescence (1)
hearing amplification and early access to oral or sign language
can improve educational and communication outcomes in children with hearing loss
vision surveillance
refer infants with cCMV for an ophthalmologic evaluation at diagnosis followed by yearly surveillance until age 5 in those with symptomatic disease
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