The serum of a newborn infant reveals a 1:32 cytomegalovirus (CMV) titer. The child is clinically asymptomatic. Which of the following courses of action would be advisable?
**Core Concept**
Congenital cytomegalovirus (CMV) infection is a leading cause of birth defects and developmental disabilities. The diagnosis of congenital CMV infection is primarily based on the presence of CMV-specific IgM antibodies in the newborn's serum.
**Why the Correct Answer is Right**
The detection of CMV-specific IgM antibodies in the newborn's serum indicates congenital infection. However, the clinical presentation can vary widely, ranging from asymptomatic to severe disease. In asymptomatic infants, follow-up with serial testing is recommended to monitor for potential development of symptoms. This approach helps to balance the risks and benefits of immediate intervention.
**Why Each Wrong Option is Incorrect**
**Option A:** Immediate antiviral therapy is not recommended for asymptomatic infants without evidence of disease progression.
**Option B:** The use of valganciclovir is not standard practice for congenital CMV infection in asymptomatic infants.
**Option C:** Monitoring for potential hearing loss and developmental delays is crucial, but this option does not address the necessity of serial testing.
**Clinical Pearl / High-Yield Fact**
For congenital CMV infection, serial testing is recommended for asymptomatic infants to monitor for potential development of symptoms, as early intervention may not be necessary.
**Correct Answer:** C.