Cytomegalovirus Infection in Infants with Hepatosplenomegaly

Cytomegalovirus (CMV) infection is the most common congenital infection with the incidence varying from 1% to 3%. At birth, approximately 10% of intrauterine infected infants demonstrate clinical symptoms and signs of infection which carries a risk of morbidity and mortality. Perinatal infection occurs in the contact of an infant with secretions and excretions of the mother with active CMV infection either by passing the birth canal or by excreting the virus into breast milk. The aim of this paper was to determine the involvement of CMV infection in the occurrence of hepatosplenomegaly in 1-5 month-old-infants and a possible involvement of recurrent maternal CMV infection in symptomatic congenital and perinatal infection. The investigated group included nine 1-5 month-old-infants with hepatosplenomegaly, hyperbilirubinemia, and increased transaminases. None of the investigated infants had evident malformations at birth. All hepatotropic viruses and HIV infection were excluded in all infants. ELISA test for detection of CMV IgM and IgG antibodies was performed on blood samples taken from mothers and their infants and antigenemia assay for CMV pp65 antigen detection in the blood. By CMV pp65 antigen detection in the blood, active CMV infection was established in 5 of the total of 9 infants with the syndrome of hepatosplenomegaly referred to the virology laboratory. One out of 5 infants was positive for anti CMV IgM antibodies. In 2 of 5 mothers, primary CMV infection in pregnancy was excluded. The presence of hepatosplenomegaly in 1-5 month old infants is indicative of congenital or perinatal CMV infection. Recurrent maternal infection can result in symptomatic, congenital or perinatal infection.