산전 초음파상 중증의 태아 수두증 소견을 보인선천성 거대세포바이러스 감염 1예
A Case of Congenital Cytomegalovirus Infection with Severe Hydrocephalus in Prenatal Ultrasonography
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CMV감염은 인간에게 가장 흔한 바이러스 감염으로 일차 감염 및 재발 감염이 가능하다. 임산부가 임신중 일차 감염된 경우 약 40%에서 태아에게 전파되고 재발 감염에 의해서는 0.5-1%에서 선천성 감염을 일으키는 것으로 되어있다. 이렇게 감염된 태아는 10%에서만 심각한 증상을 나타내고 90%에서는 무증상인 것으로 알려져 왔으나 태아감염이 있는 경우 증상발현의 가능성을 예측할 방법은 없으며, 특별한 치료도 없는 것으로 알려져 왔다. CMV 감염시 초음파상 뇌실내 비정상적인 석회화, 뇌실확장, 뇌실내 유착, 비정상적인 패턴의 뇌이랑소견, 뇌량의 저형성, 소뇌와 소뇌숨뇌수조의 이상소견, 장의 에코증가 등의 소견이 보일 수 있는데 저자들은 초음파상 뇌실내 확장 및 에코성 장의 소견을 보인 태아에 있어서 부검상 CMV감염을 1예 경험하였기에 문헌고찰과 함께 보고하는 바이다.
Abstract
Cytomegalovirus (CMV) infection is one of the most common viral infections in human and it is known to cause primary and recurrent infections. CMV is spread to the fetus in 40% of pregnancies in primary infection, while 0.5-1% of pregnancies in recurrent infection are known to cause congenital infections. Only 10% of such infections are presented with severe symptoms, with the other 90% being asymptomatic. However, there are no definite methods to predict the manifestation of fetal infections or specific treatments in such cases. Intraventricular calcification, ventriculomegaly, intraventricular adhesion, abnormal patterns of brain fissures, brain atrophy, abnormal findings of cerebellum and cisterna magna, and hyperechoic bowels can be presented by ultrasonography in CMV infection. We introduce a case of CMV infection presented as ventriculomegaly and hyperechoic bowels by ultrasonography and pathologically confirmed by autopsy.
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