Preconceptional immunity and congenital cytomegalovirus infection – a serologic pitfall

Joana Ferreira, J. Fonseca, M. Vieira
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Abstract

Congenital cytomegalovirus infections are the most prevalent intrauterine infections worldwide and result from maternal primary or non-primary infections. Diagnosis of primary cytomegalovirus infection during pregnancy is considered reliable and mainly relies on maternal serology. However, diagnosis of non-primary cytomegalovirus infection is more questionable. Herein is reported the case of a 34-week-old male newborn with congenital cytomegalovirus infection of a mother with preconceptional immunity. The organism was identified in urine by polymerase chain reaction in the first week of life. Maternal peripartum serology was the same as prior to conception. This case highlights the pitfalls of cytomegalovirus serology interpretation in non-primary infection during pregnancy. Clinicians should be aware of this and consider congenital cytomegalovirus infection, particularly when suggestive signs are present.
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孕前免疫和先天性巨细胞病毒感染——血清学陷阱
先天性巨细胞病毒感染是世界范围内最常见的宫内感染,由母体原发性或非原发性感染引起。妊娠期原发性巨细胞病毒感染的诊断被认为是可靠的,主要依赖于母体血清学。然而,非原发性巨细胞病毒感染的诊断更值得怀疑。本文报告一例34周大的男婴与先天性巨细胞病毒感染的母亲与孕前免疫。在出生后的第一周,通过聚合酶链反应在尿液中鉴定出该微生物。产妇围产期血清学与孕前相同。本病例强调巨细胞病毒血清学解释妊娠期非原发感染的缺陷。临床医生应该意识到这一点,并考虑先天性巨细胞病毒感染,特别是当有提示迹象时。
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