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All Journal Jurnal Kedokteran Brawijaya Jurnal Kesehatan Andalas Indonesian Journal of Tropical and Infectious Disease MNJ (Malang Neurology Journal) Paediatrica Indonesiana Majalah Kesehatan FKUB Indonesian Journal of Chemistry Jurnal Respirologi Indonesia ISM (Intisari Sains Medis) : Jurnal Kedokteran Indonesian Journal of Clinical Pathology and Medical Laboratory (IJCPML) Narra J Pediatric Sciences Journal
Agustin Iskandar
Departemen Patologi Klinik Dan Kedokteran Laboratorium, Fakultas Kedokteran, Universitas Brawijaya / RSUD Dr Saiful Anwar, Malang
Biochemistry, Genetics & Molecular Biology Chemical Engineering, Chemistry & Bioengineering Chemistry Earth & Planetary Sciences Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience Public Health

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Journal : Paediatrica Indonesiana

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Identifying key clinical markers for congenital cytomegalovirus infections: a PCR-confirmed case-control study Corebima, Brigitta IRV; Iskandar, Agustin; Sulistijono, Eko; Amalia, Najwa; Fauziah, Dina; Sanjaya, Hayyu Rafina
Paediatrica Indonesiana Vol. 65 No. 3 (2025): May 2025
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | DOI: 10.14238/pi65.3.2025.463-70

Abstract

Background Congenital cytomegalovirus (CCMV) infection is the leading cause of congenital infections worldwide. Clinical manifestations of CCMV are highly variable and make the clinical diagnosis difficult, especially in settings where advanced diagnostic tools are not available. Objective To identify a cluster of clinical manifestations indicative of CCMV and analyze for correlations with PCR-confirmed diagnoses. Methods This case-control study was conducted at a tertiary care hospital in Malang, East Java, and included 40 neonates clinically suspected to have CCMV. PCR specimens from urine or saliva were collected and analyzed to evaluate clinical manifestations of suspected CCMV. Demographic and clinical data were organized and analyzed using SPSS. Results Of neonates with suspected CCMV, 32.5% (n=13) had PCR-confirmed CCMV. The median age for PCR testing post-suspected CCMV was 8.50 (range 3.75 to 24.25) days. Significant correlations emerged between PCR-confirmed CCMV and symptoms such as microcephaly, jaundice, purpura, thrombocytopenia, acute liver injury, hepatomegaly, feeding difficulties, and anemia. However, seizures, low birth weight, ventriculomegaly, and intrauterine growth restriction did not show significant associations, indicating their limited utility as solitary markers for CCMV. The clinical symptoms associated with CCMV were confirmed by PCR, emphasizing the significance of certain sign and symptom clusters, such as microcephaly with thrombocytopenia (OR 41.60; P<0.001), or the traditional triad of jaundice, purpura, and hepatosplenomegaly/acute liver injury (OR 41.60; P<0.001). Conclusion Several clinical manifestations are significantly associated with PCR-confirmed CCMV infection, underscoring the diagnostic value of specific symptom combinations in identifying CCMV infection. These combinations are microcephaly and thrombocytopenia and the classic triad of jaundice, purpura, and hepatosplenomegaly/acute liver injury. 
Co-Authors Aditya Sri Listyoko Agustina Tri Endharti Aina Angelina Akmaly, Triyana Dian Dhuha Alim, Fathi Nabila Amalia, Najwa Anik Widijanti Aprilia, Andrea Aris Widayati Aryati Aryati Aryati Aryati Aryati Aryati Beti Ernawati Dewi Carla Pramudita Susanto Catur Suci Sutrisnani Corebima, Brigitta IRV Deasy Ayuningtyas Tandio Dewi, Rose Khasana Dian Nugrahenny Dina Fauziah Edi Widjajanto Eko Sulistijono Eko Sulistijono Ery Olivianto Fran Siska Hambiah Hari Oki Hambiah Hari Oki Hamid, Aulia A. Hardi Darmawan Hartanti, Khoirunisah Dwi Herdiman T. Pohan Ihda Dian Kusuma Indriana, Kristin Jahono, Maxie Felix Joko Agus Gunawan Karima, Karima Kautsarani, Intan Khadafi Indrawan Kristin Indriana Leonard Nainggolan Lindayanti Sumali Loeki Enggar Fitri Ludytajati, Ferine Maisaroh, Luluk Mayashita, Dearikha Karina Mirza, Sarah Zoraya Mufidatun Hasanah Muhammad Anshory Muhammad Anshory, Muhammad Mulyohadi Ali Mustika Dewi Nada Putri Pranidya Norwahyuni, Yuyun Novi Khila Firani Novi Kurnianingsih Nur Permatasari Nur Samsu Prameswari, Asri Pranidya, Nada Putri Pratama, Gusti Rajendra Yoga Putri Wulan Akbar Rahajuningsih Dharma Rambe, Annisa Fadhila Aurelia Rianto Setiabudy Riskawati, Yhusi Karina Rosari, M Angelina de Sanjaya, Hayyu Rafina Saptadi Yuliarto Seskoati Prayitnaningsih Settrin Chenderawasi Siska, Fran Sudjari Sudjari Suhendro Suhendro Syahfitri, Rininta Syahrul Chilmi Tri Wahju Astuti, Tri Wahju Triwahju Astuti Wafi, Muhammad Wihastuti TA Yeni Ayu Prihastuti Yeni Ayu Prihastuti Yuanita Mulyastuti Yuniasih, Kristina