Cytomegalovirus and Epstein-Barr Virus Infections.

Abstract

1. Swetha Pinninti, MD* 2. Catherine Hough-Telford, MD† 3. Sunil Pati, PhD† 4. Suresh Boppana, MD† 1. *Department of Pediatrics, University of Nebraska Medical Center/Children’s Hospital and Medical Center, Omaha, NE. 2. †Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL. 1. Although most infants with symptomatic congenital cytomegalovirus (cCMV) infection are at risk of developing sensorineural hearing loss, 10% to 15% of asymptomatic infants also develop hearing loss and require audiologic screening at regular intervals in the first few years after birth. 2. Unlike with other congenital infections, CMV seropositivity is not protective for fetal transmission. An estimated 75% of infants with cCMV are born in the United States following nonprimary maternal infections. 3. Most individuals with Epstein-Barr virus-associated infectious mononucleosis recover with supportive therapy; contrary to common belief, corticosteroid use is not the mainstay of treatment because airway compromise and splenic rupture can be rare complications. After completing this article, the reader should be able to: 1. Recognize routes of acquisition of cytomegalovirus (CMV) in the neonatal and postneonatal periods. 2. Recognize differences in presentations of congenital CMV infection, childhood infections, and infections in the immunocompromised individual. 3. Plan the diagnostic evaluation for congenital or acquired CMV infection in immunocompetent and immunocompromised children of various ages. 4. Understand management and long-term follow-up plans for infants with congenital CMV infection. 5. Describe the management and treatment of CMV infections in the immunocompromised host. 6. Explain the epidemiology of Epstein-Barr virus (EBV) infections and identify the clinical features associated with EBV infection in immunocompetent and immunocompromised children of various ages. 7. Recognize the potential complications of EBV infection in immunocompetent and immunocompromised children of various ages. 8. Plan management of children with uncomplicated infectious mononucleosis. Cytomegalovirus (CMV) is the most common cause of congenital infection and the leading nongenetic cause of sensorineural hearing loss (SNHL). CMV is also a significant cause of morbidity in preterm neonates who acquire infection postnatally …