Cytomegalovirus DNA Detection by Polymerase Chain Reaction in Cerebrospinal Fluid of Infants With Congenital Infection: Associations With Clinical Evaluation at Birth and Implications for Follow-up

Clin Infect Dis. 2017 May 15;64(10):1335-1342. doi: 10.1093/cid/cix105.


Background: DNA detection of human cytomegalovirus (hCMV) in cerebrospinal fluid (CSF) by polymerase chain reaction (PCR) is a marker of central nervous system (CNS) involvement in congenital hCMV infection (cCMV), but its prognostic value is unknown.

Methods: A multicenter, retrospective study was performed using the Spanish Congenital Cytomegalovirus Infection Database (REDICCMV; Newborns with cCMV and a lumbar puncture performed were included and classified according to their hCMV-PCR in CSF result (positive/negative). Clinical characteristics, neuroimaging abnormalities, plasma viral load, and audiological and neurological outcomes of both groups were compared.

Results: A total of 136 neonates were included in the study: 21 (15.4%) with positive CSF hCMV-PCR and 115 (84.6%) with negative results. Seventeen patients (81%) in the positive group were symptomatic at birth compared with 52.2% of infants in the negative group (odds ratio [OR], 3.86; 95% confidence interval [CI], 1.28-14.1; P = .01). Only 4 asymptomatic newborns (6.8%) had a positive CSF hCMV-PCR. There were no differences between groups regarding the rate of microcephaly, neuroimaging abnormalities, neurological sequelae at 6 months of age, or plasma viral load. Sensorineural hearing loss (SNHL) at birth was associated with a positive CSF hCMV-PCR result (OR, 3.49; 95% CI, 1.08-11.27; P = .04), although no association was found at 6 months of age.

Conclusions: A positive hCMV-PCR result in CSF is associated with symptomatic cCMV and SNHL at birth. However, no differences in neuroimaging studies, plasma viral load, or outcomes at 6 months were found. These results suggest that hCMV-PCR in CSF may not be a useful prognostic marker in cCMV.

Keywords: cerebrospinal fluid; congenital infection; human cytomegalovirus; pediatrics.; polymerase chain reaction.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Asymptomatic Infections
  • Cytomegalovirus / genetics
  • Cytomegalovirus / isolation & purification*
  • Cytomegalovirus Infections / complications
  • Cytomegalovirus Infections / congenital*
  • Cytomegalovirus Infections / diagnosis*
  • DNA, Viral / blood
  • DNA, Viral / cerebrospinal fluid*
  • DNA, Viral / isolation & purification
  • Female
  • Fetal Diseases / virology
  • Follow-Up Studies
  • Hearing Loss, Sensorineural / virology
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Microcephaly / virology
  • Neuroimaging
  • Polymerase Chain Reaction / methods
  • Retrospective Studies
  • Saliva / virology
  • Spinal Puncture
  • Viral Load


  • DNA, Viral