Title: A Study to Determine the Clinico-Epidemiological Profile of CMV Seropositive Infants Admitted in a Tertiary Care Hospital
Authors: Dr Pradeep Singh, Dr R.K. Bishnoi, Dr Pramod Sharma, Dr Kiran Suthar, Dr Sheetal Shaktawat, Dr Vikash Katewa
DOI: https://dx.doi.org/10.18535/jmscr/v5i5.115
Abstract
Background: Cytomegalovirus (CMV) infection is a common viral infection in new born and infants the clinical presentation of which is very variable. The objective was to study the clinical and epidemiological profile of CMV seropositive infants admitted in a teaching hospital of Western Rajasthan.
Methods: A prospective study was done in 30 infants who were diagnosed seropositive out of 85 clinically suspected cases of congenital/ acquired CMV infection. The epidemiological, biochemical and hematological profile of these patients was studied and their clinical presentation and associated morbidity was observed.
Results: Males (80.00%) outnumbered females (20.00%) and 90% of infants were from rural background. (76.92%) of the mothers were educated up to 8th standard or less, which was statistically significant (x2=12.03 p<0.001) 10% infants had a length for age < 2SD which was statistically significant when compared to length appropriate for age (n=21. x2=24.03 p<0.05). Pneumonia was the most common (53.33%) morbidity but accounted only for 3.33% mortality and the case fatality was 6.25% which was less than septicemia (33.33%).
Conclusion: CMV is a virus of paradoxes and can be a potential killer or a silent companion and is more prevalent in rural community. The linear growth is compromised the most and lung involvement in form of pneumonia is most frequent morbidity and though liver involved is with raised liver enzymes the synthetic functions of liver is not affected .
Keywords: cytomegalovirus, pneumonia.
References
1. Gandhoke I, Aggarwal R, Lal S, Khare S. Congenital CMV infection in symptomatic infants in Delhi and surrounding areas. Indian J Pediatr 2006;73:1095-7.
2. Malm G, Engman Ml. Congenital Cytomegalovirus Infections. Semin Fetal Neonatal Med 2007;12:154-9.
3. Cannon, M. J., And K. F. Davis. 2005. Washing Our Hands Of The Congenital Cytomegalovirus Disease Epidemic. Bmc Public Health 5:70.
4. Fowler, K. B., And R. F. Pass. 2006. Risk Factors For Congenital Cytomegalovirus Aonset Of Sexual Activity. Pediatrics118:E286-E292.
5. Fowler, K. B., S. Stagno, And R. F. Pass. 2003. Maternal Immunity And Prevention Of Congenital Cytomegalovirus Infection. Jama. 289:1008-1011.
6. Mohammed, M.K. 2007. Study Of Some Immunological And Cytogenetic Aspects In Patients Infected With Cytomeg-alov-irus. M.Sc. Thesis. University Of Baghdad.
7. Szkaradkiewicz A, Pieta P, Tułecka T, Breborowicz G, Słomko Z, Strzyzowski P. The Diagnostic Value Of Anti-Cmv And Antihpv-B19 Antiviral Antibodies In Studies On Causes Of Recurrent Abortions. Ginekol Pol 1997;68:181-6
8. Khairi S. I. 1 , Intisar K. S. 2 , Enan K. H.3 , Ishag M. Y. 4 , Baraa A. M. 2 And Ali Y. H. 2 Seroprevalence Of Cytomegalovirus Infection Among Pregnant Women At Omdurman Maternity Hospital, Sudan. Vol. 4(4), Pp. 45-49, October, 2013
9. Nabi Sn Et All Cmv Seroprevalence In Pregnant Women Jafmc June 201220.H A Diar S Afr J Ch 2014;8(4):133-137.
10. Yeager As, Grumet C, Hafleigh Eb, Arvin Am, Bradley Js, Prober Cg. Prevention Of Transfusion Acquired Cytomegalovirus Infection In Newborn Infants. J Pediatr 1981, 98: 281-287
11. Dworsky M, Yow M, Stagno S, Pass Rf, Alford C. Cytomegalovirus Infection Of Breastmilk And Transmission In Infancy. Pediatrics 1983, 72: 295-299.
12. Marco Zampoli, Mb Bch, Fcpaeds, Cert Paed Pulm,* The Pediatric Infectious Disease Journal • Vol 30, No 5, 5.2011
13. Archives of Disease in Childhood, 1977, 52, 441-446 S. D. Smith, C. T. Cho, N. Brahmagupta, And M. F. Lenahan.
14. Saudi J Gastroenterol. 2012 May-Jun; 18(3): 208–213.
15. Hanshaw JB,Dudgeon JA Viral Diseases of the Fetus and Newborn. Philadelphia: WB Saunders; 1978.
16. Osborn JE,Shahidi NT Thrombocytopenia in murine cytomegalovirus infection. J Lab Clin Med 1973;81:53-63.
17. Miyahara M, Shimamoto Y, Yamada H, Shibata K, Matsuzaki M, Ono K: Cytomegalovirus-associated myelodysplasia and thrombocytopenia in an immunocompetent adult. Ann Hematol 1997, 74:99101.
18. Nomura K, Matsumoto Y, Kotoura Y, Shimizu D, Kamitsuji Y, Horiike S, et al.: Thrombocytopenia due to cytomegalovirus infection in an immunocompetent adult. Hematology 2005, 10:405.
19. Barkovich AJ, Lindan CE. Congenital cytomegalovirus infection of the brain: imaging analysis and embryological considerations. AJNR Am J Neuroradiol. 1994;15: 703-15.
20. Coors LE1, Spencer R Retina. Delayed presentation of cytomegalovirus retinitis in an infant with severe congenital cytomegalovirus infection 2010 Apr;30(4 Suppl):S59-62.
21. Stango S. cytomegalovirus.In : Kliegman RM ,Behrman RE,Jenson HB,Stanton BF.Nelson Textbook Of Pediatrics 18th ed. philadelphia .WB saunders .Co.2007; 1377-9.
22. AAP committee on infectious diseases. cytomegalovirus infection. In: Pickering LK, Baker CJ, Kimberlin DW, Long SS, eds. Red book. 28th ed. Elk Grove Village, IL: American academy of pediatrics, 2009:275-80.