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Infección congénita por citomegalovirus: presentación de tres casos y revisión de la literatura

机译:先天性巨细胞病毒感染:3例病例介绍及文献复习

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The most frequently occurring perinatal infection is caused by cytomegalovirus (CMV); this infection is the main cause of deafness and compromise during psychomotor development in the fetus and the newborn. Screening, diagnosis and management have not been protocolized in prenatal control. The prognosis for such patients will depend on their suitable management. Three cases are presented with the aim of reviewing prenatal diagnosis and newborn management. Materials and methods: Three cases of congenital CMV infection are presented; they were diagnosed at the Hernando Moncaleano teaching hospital in Neiva (Huila department) which is a reference centre for Colombia’s south-western region. A search was made of Medline/PudMed, Embase, Lilacs and the Cochrane library databases. Results: 31 articles were found: 2 evidence-based guidelines, 6 systematic reviews, 2 consensus opinions/guidelines from the Asociación Espa?ola de Pediatría, 4 case-control studies, 4 cohort studies, 12 narrative reviews and 1 analytical decisions and costs study. Conclusion: Routine screening for CMV during prenatal control is not recommended; screening should be done in high-risk pregnant females. Usual screening methods would include specific immunoglobulin IgM (ELISA) and the G (IgG) antibody avidity test. If such test is low, then this would confirm recent infection; the confirmatory test would be PCR for CMV. PCR is used as the screening test in the newborn and the gold standard would be viral culture. Specific immunoglobulin should be used for fetal protection in females suffering gestational infection.
机译:围产期最常见的感染是由巨细胞病毒(CMV)引起的;这种感染是胎儿和新生儿精神运动发育过程中耳聋和妥协的主要原因。尚未在产前控制中进行筛查,诊断和管理。这些患者的预后取决于他们的适当治疗。提出了三例病例,旨在回顾产前诊断和新生儿管理。资料与方法:介绍了三例先天性巨细胞病毒感染病例。他们在内瓦(惠拉省)的Hernando Moncaleano教学医院被诊断出,该医院是哥伦比亚西南地区的参考中心。搜索了Medline / PudMed,Embase,Lillacs和Cochrane库数据库。结果:共发现31篇文章:2项循证指南,6篇系统评价,2篇AssociaciónEspa?ola dePediatría的共识意见/指南,4项病例对照研究,4项队列研究,12篇叙述性评论以及1项分析性决策和成本研究。结论:不建议在产前控制期间常规筛查巨细胞病毒。高危孕妇应进行筛查。通常的筛选方法包括特异性免疫球蛋白IgM(ELISA)和G(IgG)抗体亲和力测试。如果这种测试很低,那么这将确认最近的感染。验证性测试将是针对CMV的PCR。 PCR被用作新生儿的筛选测试,黄金标准将是病毒培养。对于患有妊娠感染的女性,应使用特定的免疫球蛋白保护胎儿。

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