영아 연축을 동반한 선천성 거대세포 바이러스 감염증 1례

A case of congenital CMV infection-related infantile spasm

HCMV remains the most common congenital virus infection in the world. Although the majority of congenital HCMV infections occur silently, 5% to 10% of infected newborns exhibit signs of HCMV disease in the neonatal period. Clinical manifestations include jaundice, hepatosplenomegaly, intrauterine growth retardation, microcephaly, petechial or purpuric rash, chorioretinitis, or pneumonitis. Common laboratory abnormalities in congenital HCMV infections include thrombocytopenia, anemia, hyperbilirubinemia, and elevation in serum hepatic transaminase levels. The CSF may show elevated protein content or pleocytosis. Neuroimaging studies reveal a variety of CNS abnormalities ranging from lissencephaly to multicystic encephalomalacia. Intracranial calcifications, usually periventricular, can be identified in 25% to 50% of symptomatic infants. We experienced one case of congenital CMV infection related infantile spasm. On examination at admission at 4 months of his age, he had facal seizure, microcephaly, and increased muscle tone and DTR. Brain CT revealed multiple periventricular calcification. He had EEG finding compatible with partial sezure. Seizure activity was controlled by ACTH therapy