{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,11]],"date-time":"2026-04-11T00:53:32Z","timestamp":1775868812743,"version":"3.50.1"},"reference-count":29,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T00:00:00Z","timestamp":1741910400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pathogens"],"abstract":"<jats:p>Congenital cytomegalovirus infection is the most common congenital infection worldwide and an important cause of neurodevelopmental delay and sensorineural hearing loss. Neuroimaging represents the best prognostic marker in cCMV infection. The aim of this study was to establish the role of cranial ultrasound and brain magnetic resonance imaging in the development of long-term sequelae in symptomatic and asymptomatic children with cCMV infection. Of the 47 children enrolled in the study, 25 (53.1%) were classified as symptomatic at birth. In 27\/47 patients, SNHL was diagnosed with a similar proportion among the symptomatic and asymptomatic at birth (51.8% and 48.1%, respectively; p = 1.0). Thirty case patients had available data on follow-up. Neurological sequelae were more frequently seen in patients with symptomatic cCMV, but only cerebral abnormalities seen on initial MRI results had a consequential link with the later development of motor (OR 17.5; 95% Cl: 2667, 114,846; p = 0.002) and speech disorders (OR 15; 95% Cl: 2477, 90,843; p = 0.02). Although not statistically significant, hearing deterioration was more frequent in children with abnormal MRI results (OR 5; 95% Cl: 0.846, 29,567; p = 0.121). Neuroimaging abnormalities, as identified through both cranial ultrasound (CrUS) and MRI, are critical prognostic indicators for long-term sequelae, applicable to both symptomatic and asymptomatic children.<\/jats:p>","DOI":"10.3390\/pathogens14030280","type":"journal-article","created":{"date-parts":[[2025,3,14]],"date-time":"2025-03-14T07:02:16Z","timestamp":1741935736000},"page":"280","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Characteristics, Neuroimaging Findings and Long-Term Sequelae in Children with Congenital Cytomegalovirus Infection: A Single Centre Study"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1523-1031","authenticated-orcid":false,"given":"Ivana","family":"Valen\u010dak","sequence":"first","affiliation":[{"name":"University Hospital for Infectious Disease \u201cDr. Fran Mihaljevi\u0107\u201d, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lorna","family":"Stemberger Mari\u0107","sequence":"additional","affiliation":[{"name":"University Hospital for Infectious Disease \u201cDr. Fran Mihaljevi\u0107\u201d, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maja","family":"Vrdoljak Pa\u017eur","sequence":"additional","affiliation":[{"name":"University Hospital for Infectious Disease \u201cDr. Fran Mihaljevi\u0107\u201d, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9852-5806","authenticated-orcid":false,"given":"Snje\u017eana","family":"\u017didovec Lepej","sequence":"additional","affiliation":[{"name":"University Hospital for Infectious Disease \u201cDr. Fran Mihaljevi\u0107\u201d, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5777-3763","authenticated-orcid":false,"given":"Nenad","family":"\u0160uvak","sequence":"additional","affiliation":[{"name":"School of Applied Mathematics and Infromatics, Josip Juraj Strossmayer University of Osijek, 31000 Osijek, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Goran","family":"Te\u0161ovi\u0107","sequence":"additional","affiliation":[{"name":"University Hospital for Infectious Disease \u201cDr. Fran Mihaljevi\u0107\u201d, 10000 Zagreb, Croatia"},{"name":"School of Medicine, University of Zagreb, 10000 Zagreb, Croatia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,3,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"86","DOI":"10.1128\/CMR.00062-12","article-title":"The \u201csilent\u201d global burden of congenital cytomegalovirus","volume":"26","author":"Manicklal","year":"2013","journal-title":"Clin. Microbiol. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1002\/rmv.544","article-title":"New estimates of the prevalence of neurological and sensory sequelae and mortality associated with congenital cytomegalovirus infection","volume":"17","author":"Dollard","year":"2007","journal-title":"Rev. Med. Virol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1016\/j.jpeds.2016.01.024","article-title":"Hearing in children with congenital cytomegalovirus infection: Results of a longitudinal study","volume":"172","author":"Goderis","year":"2016","journal-title":"J. Pediatr."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"178","DOI":"10.1093\/cid\/cit629","article-title":"Congenital cytomegalovirus infection: Clinical outcome","volume":"57","author":"Boppana","year":"2013","journal-title":"Clin. Infect. Dis."},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Lazzarotto, T., Bl\u00e1zquez-Gamero, D., Delforge, M.L., Foulon, I., Luck, S., Modrow, S., and Leruez-Ville, M. (2020). Congenital cytomegalovirus infection: A narrative review of the issues in screening and management from a panel of european experts. Front. Pediatr., 8.","DOI":"10.3389\/fped.2020.00013"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1093\/jpids\/pix105","article-title":"Results of a targeted screening program for congenital cytomegalovirus infection in infants who fail newborn hearing screening","volume":"8","author":"Vancor","year":"2019","journal-title":"J. Pediatr. Infect. Dis. Soc."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1136\/archdischild-2013-305276","article-title":"Feasibility and acceptibility of targeted screening for congenital CMV-related hearing loss","volume":"99","author":"Williams","year":"2014","journal-title":"Arch. Dis. Child Fetal. Neonatal Ed."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1381","DOI":"10.1111\/jpc.14428","article-title":"Integration of congenital cytomegalovirus screening within a newborn hearing screening program","volume":"55","author":"Beswick","year":"2019","journal-title":"J. Paediatr. Child Health"},{"key":"ref_9","first-page":"303","article-title":"Incidence of congenital CMV in children at a hearing rehabilitation center","volume":"11","author":"Courtmas","year":"2015","journal-title":"B-ENT"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1542\/peds.99.3.409","article-title":"Neuroradiographic findings in the newborns period and long-term outcome in children with symptomatic congenital cytomegalovirus infection","volume":"99","author":"Boppana","year":"1997","journal-title":"Pediatrics"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"325","DOI":"10.1067\/mpd.2001.112061","article-title":"Early predictors of neurodevelopmental outcome in symptomatic congenital cytomegalovirus infection","volume":"138","author":"Noyola","year":"2001","journal-title":"J. Pediatr."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"203","DOI":"10.1016\/j.braindev.2013.04.001","article-title":"Role of cerebral ultrasound and magentic resonance imaging in newborns with congenital cytomegalovirus infection","volume":"36","author":"Capretti","year":"2014","journal-title":"Brain Dev."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/j.jpeds.2006.11.032","article-title":"Cranial ultrasound scanning and prediction of outcome in newborns with congenital cytomegalovirus infection","volume":"150","author":"Ancora","year":"2007","journal-title":"J. Pediatr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"277","DOI":"10.1159\/000446690","article-title":"A prognostic neonatal neuroimaging scale for symptomatic congenital cytomegalovirus infection","volume":"110","author":"Alarcon","year":"2016","journal-title":"Neonatology"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"828","DOI":"10.1016\/j.jpeds.2013.03.014","article-title":"Clinical, biochemical, and neuroimaging findings predict long-term neuodevelopmental outcome in symptomatic congenital cytomegalovirus infection","volume":"163","author":"Alarcon","year":"2013","journal-title":"J. Pediatr."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1131","DOI":"10.1097\/INF.0000000000002455","article-title":"Role of magnetic resonance imaging and cranial ultrasonography in congenital cytomegalovirus infection","volume":"38","author":"Frick","year":"2019","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.pediatrneurol.2018.03.008","article-title":"Brain MRI findings of congenital CMV infection as a prognostic factor for neurologic outcome","volume":"83","author":"Kwak","year":"2018","journal-title":"Pediatr. Neurol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1056\/NEJMoa1404599","article-title":"Valganciclovir for symptomatic congenital cytomegalovirus disease","volume":"372","author":"Kimberlin","year":"2015","journal-title":"N. Engl. J. Med."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1016\/S0022-3476(03)00192-6","article-title":"Effect of ganciclovir therapy on hearing in symptomatic cytomegalovirus disease involving the central nervous system: A randomized, controlled trial","volume":"143","author":"Kimberlin","year":"2003","journal-title":"J. Pediatr."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1038\/jp.2017.41","article-title":"Long-term outcomes of children with symptomatic congenital cytomegalovirus disease","volume":"37","author":"Lanzieri","year":"2017","journal-title":"J. Perinatol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1205","DOI":"10.1097\/INF.0000000000001763","article-title":"Congenital cytomegalovirus: A European expert consensus statement on diagnosis and management","volume":"36","author":"Luck","year":"2017","journal-title":"Pediatr. Infect. Dis. J."},{"key":"ref_22","unstructured":"Bluestone, C.D., Stool, E.S., Alper, C.M., Arjmand, E.M., Casselbrant, M.L., and Dohar, J.E. (2003). Hearing loss. Pediatric Otolaryngology, Saunders. [4th ed.]."},{"key":"ref_23","doi-asserted-by":"crossref","unstructured":"Lo, T.H., Lin, P.H., Hsu, W.C., Tsao, P.N., Liu, T.C., Yang, T.H., Hsu, C.J., Huang, L.M., Lu, C.Y., and Wu, C.C. (2022). Prognostic determinants of hearing outcomes in children with congenital cytomegalovirus infection. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-08392-w"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"107","DOI":"10.1111\/coa.13864","article-title":"The correlation between neonatal parameters and late-onset inner ear disorders in congenital cytomegalovirus infection: A 10-year population-based cohort study","volume":"47","author":"Wu","year":"2022","journal-title":"Clin. Otolaryngol."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"373","DOI":"10.1097\/AUD.0000000000000927","article-title":"Congenital CMV-Associated Hearing Loss: Can Brain Imaging Predict Hearing Outcome?","volume":"42","author":"Craeghs","year":"2021","journal-title":"Ear Hear."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"859","DOI":"10.1080\/14767058.2019.1620725","article-title":"A new MRI severity score to predict long-term adverse neurologic outcomes in children with congenital Cytomegalovirus infection","volume":"34","author":"Lucignani","year":"2021","journal-title":"J. Matern. Fetal Neonatal Med."},{"key":"ref_27","doi-asserted-by":"crossref","unstructured":"Smiljkovic, M., Renaud, C., Tapiero, B., Lamarre, V., and Kakkar, F. (2019). Head ultrasound, CT or MRI? The choice of neuroimaging in the assessment of infants with congenital cytomegalovirus infection. BMC Pediatr., 19.","DOI":"10.1186\/s12887-019-1562-z"},{"key":"ref_28","first-page":"703","article-title":"Congenital cytomegalovirus infection of the brain: Imaging analysis and embryologic consideration","volume":"15","author":"Barkovich","year":"1994","journal-title":"Am. J. Neuroradiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"100892","DOI":"10.1016\/j.lanepe.2024.100892","article-title":"Consensus recommendation for prenatal, neonatal and postnatal management of congenital cytomegalovirus infection from the European congenital infection iniciative (ECCI)","volume":"40","author":"Chatzakis","year":"2024","journal-title":"Lancet Reg. Health Eur."}],"container-title":["Pathogens"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/3\/280\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T16:53:37Z","timestamp":1760028817000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-0817\/14\/3\/280"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,14]]},"references-count":29,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,3]]}},"alternative-id":["pathogens14030280"],"URL":"https:\/\/doi.org\/10.3390\/pathogens14030280","relation":{},"ISSN":["2076-0817"],"issn-type":[{"value":"2076-0817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,14]]}}}