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Recurrent Congenital Cytomegalovirus Chorioretinitis in a Newborn. A Case Report


Recurrent Congenital Cytomegalovirus Chorioretinitis in a Newborn. A Case Report

Purpose: To describe the clinical course, treatment, and subsequent care of a full-term newborn with atypical, unilateral, recurrent cytomegalovirus chorioretinitis.

Case report: The perinatal period of a full-term newborn girl was complicated by the development of petechiae on the skin. The initial laboratory findings were notable for thrombocytopenia, hyperbilirubinemia, and polycythemia. An ultrasound of the brain revealed cystic changes in the area of the lateral ventricles. MRI confirmed pseudocystic periventricular changes with periventricular calcifications. PCR testing confirmed CMV positivity, and the condition was diagnosed as congenital CMV infection requiring systemic treatment with ganciclovir. Indirect ophthalmoscopy revealed nonspecific lucency in the central area of the right eye, with several small hemorrhages on the retinal periphery. Although systemic therapy was initiated promptly, the original lesion reactivated multiple times on its periphery over the following months. The lesions were gradually healed, with pigmented scarring limiting the visual function of the affected eye.

Conclusion: In contrast with the focal changes in the peripheral retina observed in adults, congenital CMV infection affecting children is characterized by macular involvement. The degree of visual impairment is directly proportional to the extent of reparative scarring affecting the central retina. From the perspective of prognosis and prevention of potential late retinal complications, screening and regular ophthalmological examinations are essential.

Keywords:

childhood – chorioretinitis – cytomegalovirus – ganciclovir


Autoři: Martina Kašpráková 1;  Juraj Timkovič 1,2;  Petr Širůček 3,4;  Iveta Matyáštíková 5;  Jan Němčanský 1,2
Působiště autorů: Clinic of Ophthalmology, University Hospital Ostrava, Czech Republic 1;  Department of Craniofacial Surgery, Faculty of Medicine, University, of Ostrava, Czech Republic 2;  Clinic of Infectious Medicine, University Hospital Ostrava, Czech Republic 3;  Department of Clinic Subjects, Faculty of Medicine, University of Ostrava, Czech Republic 4;  Department of Neonatology, University Hospital Ostrava, Czech Republic 5
Vyšlo v časopise: Čes. a slov. Oftal., 81, 2025, No. Ahead of Print, p. 1-5
Kategorie: Kazuistika
doi: https://doi.org/10.31348/2025/20

Souhrn

Purpose: To describe the clinical course, treatment, and subsequent care of a full-term newborn with atypical, unilateral, recurrent cytomegalovirus chorioretinitis.

Case report: The perinatal period of a full-term newborn girl was complicated by the development of petechiae on the skin. The initial laboratory findings were notable for thrombocytopenia, hyperbilirubinemia, and polycythemia. An ultrasound of the brain revealed cystic changes in the area of the lateral ventricles. MRI confirmed pseudocystic periventricular changes with periventricular calcifications. PCR testing confirmed CMV positivity, and the condition was diagnosed as congenital CMV infection requiring systemic treatment with ganciclovir. Indirect ophthalmoscopy revealed nonspecific lucency in the central area of the right eye, with several small hemorrhages on the retinal periphery. Although systemic therapy was initiated promptly, the original lesion reactivated multiple times on its periphery over the following months. The lesions were gradually healed, with pigmented scarring limiting the visual function of the affected eye.

Conclusion: In contrast with the focal changes in the peripheral retina observed in adults, congenital CMV infection affecting children is characterized by macular involvement. The degree of visual impairment is directly proportional to the extent of reparative scarring affecting the central retina. From the perspective of prognosis and prevention of potential late retinal complications, screening and regular ophthalmological examinations are essential.

Stránka

Štítky
Oftalmologie

Článek vyšel v časopise

Česká a slovenská oftalmologie

Číslo Ahead of Print

2025 Číslo Ahead of Print
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