Congenital infection | Early postnatal infection | Infection in immunocompetent children and adolescents | Infection in immunocompromised children and adolescents | |
Clinical manifestations | At birth, 90% of cases are asymptomatic. Clinical and laboratory findings include:
| Term infants – Most infants are asymptomatic. Clinical and laboratory findings are usually transient and include:
Premature and VLBW infants – Infection can be severe and life-threatening. Clinical and laboratory manifestations include:
| Most children are asymptomatic. Clinical and laboratory findings include:
| Infection can be severe and life-threatening. Clinical and laboratory findings include:
|
Treatment | Asymptomatic infants do not require antiviral treatment. Ganciclovir or valganciclovir for symptomatic infections*. | Most term infants and asymptomatic preterm infants do not require antiviral treatment. Ganciclovir or valganciclovir for severe symptomatic infections in premature infants*. | Antiviral treatment is generally not indicated. Supportive care with hydration and fever control. | Ganciclovir or valganciclovir¶. |
Outcome | Overall mortality rate is 4 to 8%. Mortality rate with severe fulminant disease is as high as 30%. Long-term sequelae include hearing loss, cerebral palsy, intellectual disability, vision impairment, and seizures. | Term infants – No permanent sequelae. Premature and VLBW infants – Mortality rate with symptomatic infection is 5 to 10%. There does not appear to be increased risk of hearing loss, cerebral palsy, or other neurodevelopmental disability; however, long-term outcomes are not clearly understood. | No permanent sequelae. | High risk of morbidity and mortality, which depends in part on the underlying condition. |
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