Smets, Koenraad

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Ghent University Academic Bibliography

Koenraad Smets, NICU UZ GentLOOKING FOR CENTRAL NERVOUS SYSTEMINVOLVEMENT IN CONGENITAL CYTOMEGALOVIRUSINFECTION: IS LUMBAR PUNCTURE NECESSARY?Background and aim: Neuroimaging studies, including cranial ultrasound scans,cranial computerized tomography and/or magnetic resonance imaging, audiologicevaluation and funduscopy are well accepted non-invasive investigations for centralnervous system (CNS) involvement in patients with congenital cytomegalovirus(CMV) infection. However, clinicians may have to deal with refusal when lumbarpuncture for detection of CMV DNA in cerebrospinal fluid (CSF) is discussed withparents. Therefore we wanted to look whether CMV polymerase chain reaction (PCR)on CSF had been useful until now in determining CNS involvement in newborns withcongenital CMV infection in whom neuroimaging and sensorineural examinationshad been performed.Methods: We retrospectively reviewed charts of 34 newborns referred to our tertiarycentre who had CSF prelevation for CMV PCR in the working-out of their congenitalCMV infection. Results of CSF PCR, funduscopy, brainstem evoked responseaudiometry (BERA) and cerebral imaging (ultrasound and/or computerizedtomograpy scan and/or magnetic resonance imaging) were collected.Results: 7 patients (21 %) showed positive CMV PCR on CSF. In 6 of them one ormore abnormalities were found on neuroimaging (6/6) and/or BERA (2/6). In 1 babyclassified as no signs of CNS involvement and positive CSF PCR, neurologicworking-out had been limited to brain ultrasound and BERA only, while lumbarpuncture had been traumatic.Conclusion: CSF PCR is not likely to contribute to the diagnosis of CNS localizationof congenital CMV infection at birth. The less invasive neuroimaging andsensorineural investigations seem sufficient to determine whether or not there is CNSmanifestation of the disease.

Looking for central nervous system involvement in congenital cytomegalovirus infection : is lumbar puncture necessary?

https://biblio.ugent.be/publication/1850532/file/1850536

Looking for central nervous system involvement in congenital cytomegalovirus infection : is lumbar puncture necessary?

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Ghent University Academic Bibliography