巨細胞病毒是最常造成子宮內病毒感染的原因。感染率占所有活產兒的百分之0.5至2.5。早期的研究顯示,母親在懷孕期間,受到原發性巨細胞病毒感染者,有30%至40%會造成嬰兒先天性感染。大部分的先天性感染嬰兒(占80%至90%)在出生時並沒有任何徵象及症狀,僅有5%至15%會產生後遺症。因此,在診斷方面,通常是根據臨床特徵來診斷,這些特徵包括頭小畸形、癲癇發作、腦腔周圍鈣化、子宮內胎兒發育遲緩、以及各樣的神經學徵候及眼科的症狀,如脈絡膜視網膜炎、角膜的渾濁及視神經萎縮。我們所呈現的個案是一位有僵直脊椎炎的婦女,在懷孕二十二週接受例行性產檢時除了發現胎兒的頭圍較小之外,並無其他異常。嬰兒在出生後証實有巨細胞病毒及單純疹病毒感染。另外,我們發現嬰兒雙眼均有先天性白內障,而在其他的相似發表案例中並未提及有此後遺症。
Human Cytomegalovirus (CMV) is the most common cause of intrauterine viral infections, affecting 0.5-2.5% of all live births in different parts of the world [1]. Earlier publications have shown that 30-40% of primary CMV infections during pregnancy result in a congenital infection [5]. While most congenitally infected infants (80-90%) show no signs or symptoms at birth, 5-15% will eventually develop sequela. An initial diagnosis of suspected CMV is often given on the basis of characteristic clinical findings, which include microcephaly, seizure, periventricular calcification, intrauterine growth retardation, various neurological manifestations, and ophthalmological findings of chorioretinitis, corneal opacities and optic atrophy. This report discusses a case in which we observed through routine prenatal ultrasound examinations decreasing fetal cephalic dimensions beginning during the 22nd week of gestation in woman suffering from ankylosing spndylosis. We confirmed by postnatal examination that the infant suffered from both CMV and HSV (herpes simplex virus) infections. A congenital cataract (OU) was found, although a review of the current literature did not find a reference for CMV infection causing this sequela.