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Pediatrics Congenital Infections 506458e9

A 30 month old deaf boy whose development is slower than normal is being followed for congenital cytomegalovirus (CMV) infection in your clinic.The child's mother is pregnant again and is worried about her new baby. Which of the following is true?

A
The mother has antibodies to CMV that are passed to the fetus
B
The mother's infection cannot become reactivated
C
Termination of pregnancy is advised
D
The new infant should be isolated from the older child
High-Yield Explanation
CMV is the mc cause of congenital infections. C/F include hepatomegaly, splenomegaly, jaundice, petechiae, purpura and microcephaly. Symptomaticcongenital disease usually occurs when a mother has a primary CMV infection in the first trimester of pregnancy. Many of these babies die, and those who survive are severely affected. In case of reactivation of CMV infection during pregnancya maternal IgG passed transplacentally, protects the baby against infection. Most infants infected during this secondary maternal infection are asymptomatic but about 10% of them eventually manifest hearing and neurologic problems. Some recommend keeping a child with congenital CMV infection away from susceptible pregnant women because CMV excretion can persist for months to years. If infected sholy after bih, the younger sibling will probably be asymptomatic since he or she has maternal IgG in the circulation.

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