Oral valganciclovir treatment for congenital cytomegalovirus infection

Congenital cytomegalovirus (CMV) infection is the most common intrauterine infection. Approximately 10–15% of congenitally infected neonatal infants exhibit clinical evidence of congenital infection at birth. This group is more likely to experience sequelae, including microcephalus, sensor neural hearing loss, cognitive, motor and visual deficits and seizures. Previous studies have shown that approximately half of the children with symptomatic congenital CMV infection develop hearing loss, and the majority of these children experience continued postnatal deterioration of their hearing. Ganciclovir is an antiviral agent that acts against herpes viruses and has been used successfully to treat CMV infection. In addition, it has been reported that ganciclovir therapy, begun in the neonatal period in symptomatic infants with a CMV infection involving the central nervous system, prevents hearing deterioration. However, the efficacy of ganciclovir for hearing deterioration in patients beyond the neonatal period is unknown. In this report we present the case of a five-month-old girl who was treated with oral valganciclovir for progressive hearing loss resulting from congenital CMV infection.