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Cryptosporidiosis 

Cryptosporidiosis
Chapter:
Cryptosporidiosis
DOI:
10.1093/med/9780198729228.003.0060
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date: 19 November 2019

Cytomegalovirus is ubiquitous, with the majority of adults showing serological evidence of previous exposure. Infection is generally asymptomatic in healthy individuals, but, in immunocompromised patients, congenitally infected fetuses, and premature neonates infected post-natally, cytomegalovirus disease is associated with significant morbidity and mortality. Disease and mother-to-child transmission can occur following both primary infection and with reactivation/reinfection of cytomegalovirus in those previously encountering infection. Around 13% of congenitally infected neonates with no clinical evidence of disease at birth develop sensorineural hearing loss over the first few years of life. Diagnosis is generally made using polymerase chain reaction for the cytomegalovirus genome and can now be made retrospectively by retrieving the dried blood spots taken early in neonatal life and testing for viral DNA. Antiviral therapy, mainly in the form of ganciclovir and its oral prodrug valganciclovir, has been shown to be effective in preventing cytomegalovirus disease in immunocompromised patients and in preventing hearing deterioration and neurological sequelae in those with congenital disease. Other preventive measures, including potential vaccine candidates, are currently being evaluated.

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