Infección congénita por citomegalovirus en neonatos con hipoacusia detectada en el Programa de cribado auditivo

Abstract

Congenital cytomegalovirus (CMV) is the most common non-genetic cause of sensorineural hearing loss. Currently, there are no universal CMV screening programs for newborns or routine CMV testing of neonates with hearing loss in Spain, or elsewhere. This means a diagnosis of congenital CMV infection currently depends largely on clinical suspicion, leading to diagnosis of only a small proportion of symptomatic congenital CMV infected neonates. However, as neonatal hearing screening program does not routinely incorporate testing for CMV once sensorineural hearing loss is established, and as diagnostic testing for congenital CMV ideally should be done in the first three weeks of life, the window of opportunity to confirm congenital CMV is often missed in these neonates. This reduces opportunities for timely intervention. We propose determine the congenital CMV infection in infants with hearing loss identified using routine resources via the neonatal hearing screening program. The case is about a 6 and a half y/o male who has been diagnosed with symptomatic congenital CMV infection, secondary to maternal primary infection during the first term of pregnancy. Despite the treatment, he has manifested a progressive deep bilateral hypoacusia during his first four years of life. The therapeutical measures that have been adopted have not altered the fact that, besides an associated neurological defect, he still suffers from developmental delay, the clinical expression of which will be shown in some video images. The evolution of the patient brings up several questions and reflections that will be shared with the audience.