Cytomegalovirus Infection In Full Term Neonates: Clinical Analyses Of 106 Cases

Objective: To explore the clinical features of cytomegalovirus infection in full term neonates.Methods: A retrospective study was conducted on full-term neonates diagnosed as "cytomegalovirus infection" who were admitted to the first hospital of Jilin University Neonatology Department from January 2017 to December 2018.The main clinical manifestations,incidence rate and auxiliary examination results were analyzed.In addition to 2 asymptomatic patients with CMV infection,the remaining 204 children were divided into the < 14-day group(161 cases)and the < 14-day group(43 cases)according to the age of onset,and the clinical characteristics of the two groups were further compared.Results: 1.The main clinical manifestations of 206 full term neonates with CMV infection were as followings: 45 cases(21.84%)of malformations,18 cases(8.74%)of CMV pneumonia,57 cases(27.67%)of intracranial hemorrhage,54 cases(26.21%)of abnormal brain development,71 cases(34.47%)of PDA,12 cases(5.83%)of ventricular septal defect,14 cases(6.8%)of atrial septal defects,other types of congenital heart disease in 3 cases(1.46%),anemia in 79 cases(38.35%),and 32 cases(15.53%)of thrombocytopenia,24 cases of digestive tract disease(11.65%),liver damage and(or)cholestasis in 41 cases(19.9%),32 cases(15.53%)of urogenital system dysplasia,40cases(19.42%)of high indirect bilirubin levels,38 cases(18.45%)of fundus lesions,infection in 59 cases(28.64%),4 clinical deaths(1.94%)and asymptomatic in 2 cases(0.97%).2.Compared with the <14-day group,the multiple systems involvement caused by CMV infection(132 cases of vs 16),malformations(42 cases of vs 3),abnormal brain development(51 cases of vs 3),congenital heart disease(79 cases of vs 4)and high indirect bilirubin(39 cases of vs 1)were significantly higher than that in the ?14-day group.However,the CMV pneumonia were significantly lower in < 14-day groupcomparing with the ?14-day group(P<0.05).3.The classification of white blood cells was as followings: 93 cases(45.15%)with high proportion of lymphocytes,48 cases(23.30%)with high proportion of monocytes,32 cases(15.53%)with high proportion of both lymphocytes and monocytes.4.179 cases(97.3%)were positive for CMV-pp65,23cases(12.5%)were positive for CMV-IgM antibody,the difference was statistically significant.Conclusion: Clinical manifestations of CMV infection in full term neonates are diverse and lack of specificity.CMV infection of full term neonates can affect a single organ or system,or multiple organs and/or systems,and can even be fatal.Neonates infected with CMV at full term were more likely to have multiple system involvement,malformations,intracranial hemorrhage,abnormal brain development,congenital heart disease and high indirect bilirubinemia at the age of < 14 days,while CMV pneumonia was more likely to occur at the age of ?14 days.The positive rate of CMV-pp65 detection in full-term CMV-infected neonates was higher than that of CMV-IgM detection.