Inapparent Congenital Cytomegalovirus Infection with Elevated Cord IgM Levels

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Abstract
A longitudinal clinical, virologic and immunologic study found 18 patients with inapparent congenital cytomegalovirus infection among 267 neonates with elevated umbilical-cord IgM levels. Virus excretion persisted in most patients through the third year of life, and the concomitant antigenic stimulation resulted in an accelerated development of immunoglobulins M and G and in continued complement-fixing antibody production in 14. Some degree of sensorineural hearing loss occurred in nine of 16 patients tested as compared with two of 12 controls, and, in four, an auditory handicap was either proved or considered likely. A trend toward subnormal intelligence was observed in the infected children, and two manifested definite mental and social disability. Cytomegalovirus infection probably has an important causal role in mild to moderate auditory and mental dysfunction in childhood. (N Engl J Med 290:291–296, 1974)