Diagnosis and treatment of cytomegalovirus infection in pregnant women and newborns


DOI: https://dx.doi.org/10.18565/epidem.2020.10.1.86-95

Khabelova T.A., Valishin D.A., Kutuev O.I., Prosvirkina T.D., Larshutin S.A., Balyagutdinov E.M.

1) Bashkir State Medical University, Ministry of Health of Russia, Ufa, Russia; 2) Infectious Diseases Clinical Hospital Four, Ufa, Russia
Objective. To provide the clinical and laboratory characteristics of cytomegalovirus infection (CMVI) in a pregnant woman and a newborn infant.
Subjects and methods. Examinations were made in a pregnant woman with reactivated CMVI confirmed by ELISA and in a neonatal girl diagnosed with acute congenital (antenatal) generalized CMVI confirmed by ELISA and PCR. Clinical and anamnestic, laboratory and instrumental techniques, such as chest X-ray, ECG, echoCG, computed tomography and magnetic resonance imaging of the brain and spinal cord, computed tomography of the chest, and ultrasound of the abdominal cavity, were also used.
Results. A follow-up was made in a 29-year-old pregnant woman, in whom a blood test screening for TORCH infections revealed anti-CMI IgM, anti-CMV IgG, an avidity index of 0.389 in the absence of CMV DNA in blood and urine. The baby was born at 40–41 weeks’ gestation with a clinical symptom complex of generalized CMVI, the main manifestation of which was brain damage as multiple calcifications and cysts. The neonate’s blood displayed anti-CMV IgM antibodies and low-grade anti-CMV IgG antibodies and a CMV DNA level of 1.5 x 102 copies/ml. There was a high concentration of CMV DNA in urine and buccal contents. During combination therapy with cymevene, neocytotect, the baby showed a reversal of pneumonia, thrombohemorrhagic syndrome, and hepatitis with the normalization of liver transaminases, and a decrease in CMV load in blood.
Conclusion. CMVI is an important problem of obstetrics, gynecology, and perinatology, which occupies a special place among intrauterine infections and affects reproductive health, which necessitates the development of new methods for the prevention and treatment of this disease.
Keywords: congenital cytomegalovirus infection, pregnancy
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About the Autors

Tamara A. Khabelova, Cand. Med. Sci., Associate Professor, Department of Infectious Diseases with Course of the Institute of Advanced Professional Education, Bashkir State Medical University, Ministry of Health of Russia, Ufa, Russia; e-mail: thabelova@mail.ru, ORCID ID: 0000-0002-7050-5210.
Prof. Damir A. Valishin, MD, Head, Department of Infectious Diseases with Course of the Institute of Advanced Professional Education, Bashkir State Medical University, Ministry of Health of Russia, Ufa, Russia; e-mail: damirval@yandex.ru; ORCID ID: 0000-0002-1811-9320
Oleg I. Kutuev, Cand. Med. Sci., Associate Professor, Department of Infectious Diseases with Course of the Institute of Advanced Professional Education, Bashkir State Medical University, Ministry of Health of Russia, Ufa, Russia; e-mail: okutuev@yandex.ru; ORCID ID: 0000-0002-6945-0291
Tatiana D. Prosvirkina, Cand. Med. Sci., Associate Professor, Department of Infectious Diseases with Course of the Institute of Advanced Professional Education, Bashkir State Medical University, Ministry of Health of Russia, Ufa, Russia; e-mail: prosvirkinatd@mail.ru; ORCID ID: 0000-0001-7903-6804
Sergey A. Larshutin, Cand. Med. Sci., Assistant Lecturer, Department of Infectious Diseases with Course of the Institute of Advanced Professional Education, Bashkir State Medical University, Ministry of Health of Russia, Ufa, Russia; e-mail: larshutin@mail. ru; ORCID ID: 0000-0003-4258-1643   
Eduard M. Balyagutdinov, Physician, Children’s Diagnostic Department, Infectious Diseases Clinical Hospital Four, Ufa, Russia; e-mail: Eddu68@list.ru


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