Congenital and acquired cytomegalovirus infection and hearing evaluation in children

Objectives

Congenital cytomegalovirus (CMV) infection is one of the most common intrauterine diseases. In all, 1% of live births is affected by cytomegalovirus infection, while 90% neonates with perinatal infection do not show symptoms of disease. Symptomatic CMV is present in 5–10% of children. Typical clinical signs of CMV infection are microcephalia, mental retardation, progressive major amblyacousia, and neuromuscular infection. Hypoacusis is present in 30–60% of children with congenital symptomatic CMV – in most cases it is bilateral and applies to high frequency hearing loss. The purpose of this article is to emphasize the importance of hearing evaluation in children with congenital and acquired cytomegalovirus infection.

Patients and methods

A group of 70 children had serological and genetic screening for CMV DNA, using PCR method, in urine and blood. In this group, 52 children were diagnosed with congenital CMV and 18 children had acquired CMV. Audiological examinations including PTA, ABR, TEOAE and immittance audiometry were performed.

Results

Bilateral sensorineural hearing losses were found in 9 children, associated with mental and physical retardation, brain malformation and microcephalia, and unilateral losses in 3 children. In 40 cases, we did not observe hearing loss, although the level of bilirubin was high, and splenomegaly, hepatomegaly and paralysis of facial nerve were present. In the group of children with acquired CMV, we did not notice hearing loss.

Conclusions

This research proved that CMV infection often caused hearing loss. In spite of this, all children with congenital and acquired CMV should be monitored and assessed throughout their lifetime by an audiologist.