A term neonate diagnosed with symptomatic congenital CMV in the first week of life has petechiae, hepatosplenomegaly, thrombocytopenia, and periventricular calcifications. Which treatment is recommended?
- A Oral valganciclovir for 6 weeks
- B Oral valganciclovir for 6 months, monitoring for neutropenia ✓
- C IV ganciclovir for 6 weeks only
- D Acyclovir for 21 days
Correct answer: B. Oral valganciclovir for 6 months, monitoring for neutropenia
Explanation
Symptomatic congenital CMV disease warrants antiviral therapy, and current practice is oral valganciclovir for 6 months, a duration shown to improve hearing outcomes compared with 6 weeks. The main dose-limiting toxicity is myelosuppression, especially absolute neutropenia, requiring regular counts. Acyclovir has negligible activity against CMV and is used for HSV. Six-week courses are now inadequate for symptomatic disease.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.