CMV-Infektionen bei Neugeborenen: Prävalenz, Diagnostik und Therapie

Zusammenfassung

Infektionen mit Cytomegalieviren fordern sowohl den Geburtshelfer als auch den Pädiater heraus. Sie sind die häufigste Ursache einer kongenitalen Virusinfektion. Die Feten von seronegativen Schwangeren belastet das Risiko der bleibenden Organschädigung bei Primärinfektion. Seropositive Schwangere übertragen zwar seltener das Virus intrauterin, sie reaktivieren jedoch postnatal die Virusreplikation und übertragen das Virus über die Muttermilch, vor allem auch auf sehr unreife Frühgeborene.

In dieser Übersichtsarbeit werden aus Sicht des Neonatologen die Auswirkungen der intrauterinen und der postpartalen Virusübertragung auf das Neugeborene behandelt.

Die klinischen Symptome und die Langzeitauswirkungen der CMV-Infektionen des Neugeborenenalters sind unterschiedlich in Abhängigkeit vom Infektionszeitpunkt. Auch die Prävalenz der Infektion, der diagnostische Zugang, sowie die Ansätze zur Prävention und Behandlung sind verschieden.

Abstract

Infections with cytomegalovirus (CMV) are still a challenge for obstetricians as well as pediatricians. CMV is the most common congenital virus infection. In the case of a primary infection, the fetus of a seronegative pregnant woman is exposed to the risk of permanent organ damage. The intrauterine transmission rate in CMV-seropositive women is low but postnatal reactivation and transmission by breast milk occur more frequently, especially in premature babies. In this review we discuss the consequences of intrauterine and postpartum transmission from a neonatological point of view. With regard to the severity of the symptoms and possible long-term consequences, the time of infection with CMV is of great importance. Prevalence, diagnostic tools, and possible options for treatment or prevention differ for each mode of CMV infection.

Schlüsselwörter

CMV-Infektion - kongenital - postnatal - Neugeborene

Key words

Cytomegalovirus - Intrauterine infection - Postnatal infection - Neonate

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