J Korean Med Sci.  2020 Aug;35(30):e244. 10.3346/jkms.2020.35.e244.

Audiologic Status of Children with Confirmed Cytomegalovirus Infection: a Case Series

• Kim JH
• Roh KJ
• Nam GS
• Son EJ

• KMID: 2505189
• DOI: http://doi.org/10.3346/jkms.2020.35.e244

Abstract

Background
Congenital cytomegalovirus (CMV) infection is the most common non-genetic cause of sensorineural hearing loss (SHNL) in children. Only about 10% to 15% of children with congenital CMV are symptomatic, and most are not diagnosed at birth. About 7% to 15% of clinically asymptomatic patients may develop later complications, including SNHL, which is the most common sequela in clinically asymptomatic patients. In this study, hearing status was investigated in children with confirmed CMV infection and neonatal hearing screening (NHS) histories were reviewed to explore hearing loss caused by CMV.
Methods
The medical records of 58 children who were diagnosed with confirmed CMV infection were reviewed for clinical symptoms and signs of CMV infection. Hearing status was evaluated with age-appropriate audiological test batteries.
Results
A total of 58 children (M:F = 32:26 patients; age at study: mean, 5.62 years, range, 1-10 years) were diagnosed serologically with CMV infection (14 patients, 21.1%), or diagnosed via PCR of serum (5, 7.9%) and/or PCR from urine (19, 26.8%). Hearing loss was confirmed in 11 children (19.0%), being bilateral in 6 (54.5%), and unilateral in 5 (45.5%). Note that 7 of 17 ears with hearing loss passed NHS and were diagnosed only after re-evaluation when CMV infection was identified.
Conclusion
Hearing loss is a serious complication of CMV infection in children. Our results highlight the importance of timely audiological evaluation in children with clinically symptomatic CMV infection even if they pass NHS.

Keyword

Hearing Loss; Cytomegalovirus; Newborn Screening

Figure

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  Fig. 1 Age at confirmation of CMV infection (n = 58). The figure shows distribution of patients who were confirmed of CMV infection at each age group, including 6 patients with congenital CMV infection confirmed within the first 2 weeks after birth.CMV = cytomegalovirus.

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  Fig. 2 Age at detection of HL and diagnosis of CMV infection (n = 11). Most patients were diagnosed with CMV infection before hearing loss was confirmed.HL = hearing loss, CMV = cytomegalovirus.

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