Which of the following is commonly seen in fetus with congenital CMV infection?

Appeared in: AIIMS Bhatinda NO - 2019

Explanation

Congenital Cytomegalovirus (CMV) is the most common congenital viral infection.
Sensorineural hearing loss is the most frequent long-term sequela of congenital CMV, affecting both symptomatic and a portion of asymptomatic infants.
The hearing loss can be present at birth or have a delayed onset, and it can be progressive, necessitating regular audiological follow-up.
Other common findings in symptomatic infants include petechiae, jaundice, hepatosplenomegaly, microcephaly, and intrauterine growth restriction.

Option B: Myocarditis (inflammation of the heart muscle) is a very rare manifestation of congenital CMV infection.
Option C: While blood dyscrasias such as thrombocytopenia and anemia can occur in symptomatic congenital CMV, they are not the most common finding. Hearing loss is far more prevalent as a long-term complication.
Option D: Pulmonary cysts are not a recognized feature of congenital CMV infection. CMV can cause pneumonitis, but not typically cystic lung disease.

Clinical Relevance

Nursing practice connection: Knowing Clinical manifestations of congenital Cytomegalovirus (CMV) infection helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Nurses play a crucial role in identifying infants at risk for congenital CMV, particularly those who fail their newborn hearing screen.
It is essential to educate parents about the importance of regular audiology appointments for children diagnosed with congenital CMV, as hearing loss can be progressive or have a delayed onset.
What if? If an infant with confirmed congenital CMV passes the initial newborn hearing screen, the plan of care does not change. The infant still requires routine, long-term audiological monitoring (e.g., every 3-6 months for the first few years) because of the high risk of late-onset or progressive hearing loss.

How to Approach the Question

First, identify the core of the question: it asks for the most common finding in congenital CMV infection.
Recall the classic signs and symptoms of congenital CMV. Note that about 90% of cases are asymptomatic.
For the 10% who are symptomatic, think about the most frequent and lasting complications. The TORCH infections (Toxoplasmosis, Other, Rubella, CMV, Herpes) are known for causing CNS and sensory organ damage.
Evaluate each option. While blood issues can occur, hearing loss is the single most common long-term problem.
Select the option that represents the most prevalent sequela, which is sensorineural hearing loss.

Concept Tested & Keywords

Concept Tested: Clinical manifestations of congenital Cytomegalovirus (CMV) infection.
Stem keywords: fetus, congenital CMV infection, commonly seen
Lead-in keywords: Which of the following

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E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 2019-2021

E6 Medicine Harrison 22e Part 1 p. 1554-1556

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