From the Guidelines
Cytomegalovirus (CMV) infection can cause a range of symptoms, including hearing loss, vision problems, intellectual disability, and other neurological and developmental issues, particularly in congenital cases or in individuals with weakened immune systems. The symptoms of CMV infection can vary widely depending on the individual's immune status and the severity of the infection. In healthy individuals, CMV infection may cause no symptoms or mild symptoms such as fever, fatigue, and sore throat, resembling mononucleosis 1. However, in immunocompromised individuals, CMV can cause more severe symptoms affecting various organs, including pneumonia, retinitis, gastrointestinal issues, hepatitis, and neurological problems.
Some of the key symptoms of CMV infection include:
- Hearing loss, which can be present at birth, late-onset, or progressive in nature 1
- Vision problems, including retinitis and potential blindness
- Intellectual disability and developmental delays
- Small head size, seizures, and liver/spleen/lung damage in congenital cases
- Balance, stability, and coordination disorders due to vestibular dysfunction, which may be progressive or late-onset in nature 1
It is essential to note that CMV symptoms can be subtle at birth and may be underdiagnosed in the absence of confirmatory testing. Early detection and comprehensive care are crucial for managing CMV infection and preventing long-term sequelae, particularly in children with congenital CMV. This may involve a multidisciplinary team of specialists, including otolaryngology, audiology, ophthalmology, speech-language pathology, and infectious disease specialists 1. Antiviral medication, such as valganciclovir, may be recommended in certain cases to improve developmental outcomes and prevent further progression of hearing loss 1.
From the Research
CMV Symptoms
- CMV infection can present with various non-specific findings, including pneumonitis, which is considered a rare manifestation 2
- Congenital CMV infection can also present with meningoencephalitis and chorioretinitis 2
- CMV disease can cause respiratory distress in neonates 2
- CMV infection can also lead to neurodevelopmental sequelae and hearing outcomes 2
CMV Infection Treatment
- Ganciclovir and valganciclovir are beneficial for improving neurodevelopmental sequelae and hearing outcomes of congenital CMV infection 2
- Foscarnet and cidofovir are also used to treat CMV infection, but are often poorly tolerated due to high rates of toxicity, such as renal dysfunction and neutropenia 3, 4
- Valganciclovir is an orally administered prodrug of ganciclovir and is as effective as intravenous ganciclovir for the treatment of AIDS-related CMV retinitis 5