Table 1.

Possible signs and symptoms in children with congenital CMV (reproduced from Luck et al.).

CLINICALLY DETECTABLE SYMPTOMS/SIGNS

Physical examination

Small for gestational age (birth weight < −2 standard deviations for gestational age) Microcephaly (head circumference < −2 standard deviations for gestational age) Petechiae or purpura (usually found within hours of birth and persist for several weeks) Blueberry muffin rash (intra dermal hematopoiesis) Jaundicea Hepatomegaly Splenomegaly

Neurologic physical examination

Microcephaly (head circumference < −2 standard deviations for gestational age) Neurologic signs (lethargy, hypotonia, seizures, poor sucking reflex)

ABNORMALITIES DETECTED INCIDENTALLY OR THROUGH

SUBSEQUENT INVESTIGATION/SPECIALIST EXAMINATION

Laboratory results

Anemia Thrombocytopenia (occurs in the first week but platelets often increase spontaneously after the second week) Leukopenia, isolated neutropenia Elevated liver enzymes (alanine aminotransferase/aspartate aminotransferase) Conjugated hyperbilirubinemia

Cerebrospinal fluid

Abnormal cerebral fluid indices, positive CMV DNA

Neuroimaging

Calcifications, periventricular cysts, ventricular dilatation, subependymal pseudocysts, germinolytic cysts, white matter abnormalities, cortical atrophy, migration disorders, cerebellar hypoplasia, lenticulostriatal vasculopathy

Hearing test

Sensorineural hearing loss uni- or bilaterally

Visual examination

Chorioretinitis, retinal hemorrhage, optic atrophy, strabismus, cataracts

CMV, cytomegalovirus.

^aCMV-associated jaundice can be present at the first day after birth and usually persists longer than physiologic jaundice.