Etiologic diagnosis of cytomegalovirus infection in the newborn and infant

Human cytomegalovirus (HCMV) infection in neonates or in young infants is clinically inapparent in the majority of cases. Nevertheless, in many of them earing defects or impairment of the central nervous system or of the liver or of the immunity, will appear later in the life. The laboratory diagnosis of CMV infected child is important because its identification implicates both the ascertaiment of sequelae in the follow up of the patient as the decision to take about a possible specific treatment. We have found 138 CMViruric subjects over 487 tested and we have divided the CMV positives in 4 groups, according to their age. The time necessary for the appearance of the focal cytopatic effect (CPE) typical of CMV in fibroblasts inoculated with the urine, was of about five days in the first group (0-4 months of age) and was significatively shorter in comparison to the other 3 groups of older patients. Specific IgM serology in the 138 CMViruric subjects was demonstrated in only 28 cases (20,2%), while in 103 resulted negative and in 7 dubious. We conclude that the classical urine culture onto fibroblasts in still a fundamental approach for the laboratory diagnosis of CMV infection in the neonate or young infant, with a positive result reached in few days. It is possible that the sophisticated and rapid but more expensive methods of CMV identification, as polymerase or ligase-amplification techniques, will make culture obsolete in the future.